Toxic Hospital Practices May Fuel Readmissions
And extremely important and do-able is that hospital teams can avoid waking people up in the middle of the night for tests or bathing or vital signs if they can be reasonably performed during waking hours.
What person who has spent any time as an inpatient, only to be discharged dazed and confused, like they haven't slept in weeks after being poked and prodded at all hours of the night, wouldn't appreciate that?
Smart hospitals are starting to do just that, to see what impact "sleep protocols" might have, Krumholz and Pandharipande tell me. I'm anxious to hear.
Krumholz thinks hospitals and policy experts, including himself, have not spent enough time working to understand how to make these transitions better for their patients who can't be expected to do what they're told when the hospital experience has disoriented their lives to this extent.
Hospitals, of course, are unhappy with being blamed for readmissions. They're now in a performance period for reimbursement cuts of up to 3% of their Medicare base DRG payments if their readmission rates are significantly higher than expected. Many hospital leaders don't think they can control, nor should they control, what happens to a patient once he or she leaves the hospital grounds.
"I feel bad for hospitals," Krumholz says. "For once they're going to have to really focus on making the transition easier for patients, and maybe create a healing environment that's more supportive. I know that's a hardship.
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