Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists

Abstract

The period following discharge from the hospital is a vulnerable time for patients.About half of adults experience a medical error after hospital discharge, and 19%-23% suffer an adverse event, most commonly an adverse drug event. This article reviews several important challenges to providing high-quality care as patients leave the hospital. These include the discontinuity between hospitalists and primary care physicians, changes to the medication regimen, new self-care responsibilities that may stress available resources, and complex discharge instructions. We also discuss approaches to promoting more effective transitions of care,

Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use

“…[20][21][22][23][24][25][26] Oftentimes, the hospital physician is first introduced to their patient at hospital admission and must rely on the history, physical exam and medical record when making medical decisions. [27][28][29][30][31] For this reason, the hospital physician may be unaware of a patient's drug or alcohol use or mental illness, all risk factors for opioid misuse. [32][33][34] Unfamiliarity between the hospital physician and the patient, and variability in opioid prescribing by hospital physicians, may contribute to chronic opioid use.…”

Teaching the Use of Respiratory Inhalers to Hospitalized Patients with Asthma or COPD: a Randomized Trial

“…1,2 These interventions have largely focused on broad concepts such as medication reconciliation, 3 patient-care handoffs, 4,5 and adherence to prescribed therapies. 6 The use of hospitalbased education to improve patient self-management skills is an under-studied component of this care.…”

Factors Associated With Older Patients' Engagement in Exercise After Hospital Discharge

“…17,18,26 Patients may need ongoing support following discharge to overcome medical barriers that prevent engagement 298 in exercise and other physical activities. Other studies have concluded that older patients 299 require additional rehabilitation after discharge, 5 and that more attention is required to ensure 300 effective transition from hospital to home 8,46 and promote increased activity levels after 301 hospitalization. 4 Further studies are required to confirm the factors that were identified in this 302 study as facilitating engagement in exercise programs in this population.…”