REDUCING REHOSPITALIZATION Israeli hospital patients are kept in wards for an average of only four days, shorter than in most Western countries. This is not because Israeli doctors have some magic touch that makes patients get better faster, but because of a serious shortage of hospital beds, forcing a “warm bed” policy. Now a study carried out at Assaf Harofeh Medical Center in Tzrifin has found that too- short hospitalizations often lead to patients having to return for more hospital care for the same illness. Fully 26% of the elderly in the past three months were rehospitalized at Assaf Harofeh. This causes a heavy economic burden on the health system. In the US, a quarter of the expenses of health insurance companies is spent on rehospitalization; that comes to $14 billion a year.But research abroad has found that almost half of all rehospitalization can be prevented if erroneous diagnoses are not made the first time; and if there were no unsuitable treatment, premature discharge, lack of a discharge program and poor communication among the hospital, family and their doctors.The Assaf Harofeh study included 100 patients with an average age of 69 who were admitted for the second time within a short period after first being in the internal medicine department. The patient, a relative and a hospital nurse provided the reasons for the rehospitalization. The nurses mostly blamed the patient’s failure to take medications, stress, anxiety, poor advice and the lack of followup by the doctor in the community.The researchers recommended that the hospital teams prepare a checklist of information for the patient and his family; that the community nurse be contacted by a hospital nurse and inform her about the discharge and what more had to be done, including a personal visit within 48 hours, and ensuring that the discharge recommendations be carried out. They also suggested that a new staff position – discharge nurse – be established to improve the planning and implementation of discharge to reduce the number of rehospitalizations.
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REDUCING REHOSPITALIZATION Israeli hospital patients are kept in wards for an average of only four days, shorter than in most Western countries. This is not because Israeli doctors have some magic touch that makes patients get better faster, but because of a serious shortage of hospital beds, forcing a “warm bed” policy. Now a study carried out at Assaf Harofeh Medical Center in Tzrifin has found that too- short hospitalizations often lead to patients having to return for more hospital care for the same illness. Fully 26% of the elderly in the past three months were rehospitalized at Assaf Harofeh. This causes a heavy economic burden on the health system. In the US, a quarter of the expenses of health insurance companies is spent on rehospitalization; that comes to $14 billion a year.But research abroad has found that almost half of all rehospitalization can be prevented if erroneous diagnoses are not made the first time; and if there were no unsuitable treatment, premature discharge, lack of a discharge program and poor communication among the hospital, family and their doctors.The Assaf Harofeh study included 100 patients with an average age of 69 who were admitted for the second time within a short period after first being in the internal medicine department. The patient, a relative and a hospital nurse provided the reasons for the rehospitalization. The nurses mostly blamed the patient’s failure to take medications, stress, anxiety, poor advice and the lack of followup by the doctor in the community.The researchers recommended that the hospital teams prepare a checklist of information for the patient and his family; that the community nurse be contacted by a hospital nurse and inform her about the discharge and what more had to be done, including a personal visit within 48 hours, and ensuring that the discharge recommendations be carried out. They also suggested that a new staff position – discharge nurse – be established to improve the planning and implementation of discharge to reduce the number of rehospitalizations.