Toxic Hospital Practices May Fuel Readmissions

Cheryl Clark, October 3, 2013

In the process of giving life-saving therapies, healthcare providers are often unaware that the dehydration, malnutrition, deconditioning, and information overload that happen during hospital stays may have long-term consequences to the cognitive function of vulnerable patients.

Harlan Krumholz, MD, director of the Center for Outcomes Research and Evaluation at Yale School of Medicine, says that while patients get their diagnosed illnesses treated during their hospital stays, some can leave the hospital a lot worse off than than how they came in.

He's calling this scenario "the hospitalization toxic." In a paper in the New England Journal of Medicine earlier this year, he called it "post-hospital syndrome."

See Also: ICU Delirium Linked to Post-Discharge Cognitive Decline

'Regardless of what it's called, the result is that these patients are weaker, more prone to infections, cognitively impaired, and seem more vulnerable, more susceptible to adverse events such as falls. "Nothing's quite working right. They're not thinking straight."

But hospital teams don't think about this. Case managers, clinicians, nurses, discharge planners, and physicians all tell the patients what to do next to keep them from being readmitted and to speed their recovery:

  • Here's how to take your medication.
  • See this doctor next Tuesday.
  • Eat less salt.

But patients don't hear a word and can't recall any of it the next day. "Their brains aren't working like they used to," Krumholz says.


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