A 75-year-old lady is admitted to the hospital with a bowel blockage caused by adhesions from earlier uterine cancer surgery and radiation. She has had hypertension, atrial fibrillation, and peripheral vascular disease in the past. She is discharged on many drugs, including a greater dose of her warfarin, after a lengthy hospital stay complicated by a pulmonary embolus. The patient has appointments with her internist, gynecologist, cardiologist, and gastroenterologist. She lives on her own and has previously managed her care requirements satisfactorily. Her adult daughter is helpful, although she lives out of state. Which of the following strategies would be most successful in increasing her outpatient treatment adherence?

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Quizplus · Accepted Answer

Eductional Objective: Patients are at greater risk during the transition from inpatient to outpatient treatment. Individuals with many medical issues, complicated prescription regimes, limited health literacy, and little social support are more vulnerable. A organized approach that employs a complete discharge checklist is the most effective technique for reducing bad outcomes and eliminating needless readmissions. The checklist should include instructions and patient education materials at the appropriate reading level to ensure a smooth transition from the hospital to the outpatient environment. Key components of the discharge checklist include detailed medication instructions (purpose, dosing schedule, and adverse events), follow-up appointments with the primary care provider and any specialists, pending laboratory measurements or tests, and an emergency contact number with specific directions on how to contact the patient.  Medication changes that have occurred during the hospitalization (eg, new medications, discontinued medications, changes in dose or frequency) should be clearly identified on the checklist to reduce the risk of medication errors.

A 75-Year-Old Lady Is Admitted to the Hospital with a Bowel