Hospital readmissions are, by and large, a bad thing. For patients, they can waste time, suck up energy that would be better dedicated to healing and bring on avoidable medical bills. For hospitals, they can indicate preventable expenses for the health care system, backlogs in emergency departments and poor patient care.
“Typically, readmissions that occur within the first seven days are related to the whole discharging process,” says Dr. David Gifford, a geriatrician and senior vice president of the American Health Care Association’s quality and regulatory group. “The instructions weren’t clear, arrangements for medication at home weren’t made, home health care wasn’t arranged or was late, there was no follow-up appointment [or] the information from the hospital stay did not get communicated to the health care team that’s caring for that person at home.”
But sometimes, going back to the hospital after you’ve returned home (and hoped to stay there) is necessary, even life-saving. “People look at it as ‘get out and stay out,’ but when you should think about going back is important too,” says Dr. Andrew Dunn, a professor of medicine and chief of the division of hospital medicine at Mount Sinai Health System in New York City.
[Read: How to Survive Your Hospital Stay.]
Here are some signs you may need to return to the hospital:
1. A call to the doctor confirms you should return.
Unless you think you’re experiencing an emergency, the best course of action before shuttling yourself back to the hospital is to call the surgeon, cardiologist or other lead clinician who treated you at the hospital, Dunn says. “They’ll know the specific circumstances of your condition when you left,” he says. While primary care physicians can be good resources, too, most hospital readmissions happen quickly after discharge, meaning patients haven’t had a chance to catch up with their general docs yet.
Of course, calling the doc who knows the most about the intricacies of your treatment requires you insist on getting his or her direct line before leaving the facility. Ideally, you received that number and more when you were discharged from the hospital, including written instructions on how and when to take medications, scheduled follow-up appointments and copies of lab tests, Gifford says. “Have clear instructions on when to call,” he says. “Ask, ‘What’s the trajectory here? What is normal going to be for me?’ Those are hard conversations, but they’re really important to have.”
2. You have certain symptoms.
Some symptoms after discharge are expected. “Recovery is a process — no one recovers overnight,” says Seun Ross, a nurse practitioner and director of nursing practice and work environment at the American Nurses Association. “Whether you had surgery on your shoulder or just had a baby or you had a heart attack or your kidneys aren’t working well, just because it’s one specific part of your body doesn’t mean your whole body doesn’t need to recover,” she says.
[See: 6 Nonopioid Ways to Ease Postoperative Pain.]
But some symptoms raise alarm. For instance, after surgery, if you have a fever, new or smelly discharge at the sight of operation or severe pain, you should be seen promptly, Dunn says. If you had a procedure to open up a blocked artery and experience severe chest pain or shortness of breath — not just mild discomfort or difficulty exercising at your old level — you shouldn’t hesitate to go back in. Or, if you were treated for pneumonia and can’t catch your breath to the point of feeling like you’re going to pass out, “you need to call me or go back to the hospital immediately,” Dunn tells patients.
3. You feel worse than when you entered the hospital.
Again, not feeling like your healthiest self is expected after a hospital stay. “We don’t send anyone home feeling well,” Dunn says. But clinicians do send patients home when they’ll no longer benefit from hospital care but will benefit from recovering at home or another type of facility like a rehab center or short-term nursing facility. “Know that you’re capable of getting better; otherwise, you would have never been discharged,” Ross says.
That said, not all patients recover as planned. To determine your line between normal recovery and potential danger, follow Ross’s rule of thumb: If you feel worse than you did when you first came to the hospital, you should return. “Discomfort with certain conditions is expected, but that amount of discomfort should lessen every day, and as the days go by, you should notice an increase in energy and stamina levels,” she says.
4. You feel “impending doom.”
No matter what’s covered in your discharge instructions or what general guidelines say about when it is and isn’t appropriate to be readmitted to the hospital, remember that you know your body best. If your gut feeling is one of “impending doom” Ross says, heed your instincts.
[See: U.S. News Best Hospitals Rankings.]
“Every patient should feel empowered to call their primary care doctor or health care provider and if they still feel that sense of ‘I need to go back,’ I don’t think there’s anyone who will tell that patient, ‘Don’t come back,'” she says. “You are your own best advocate. Make that initial phone call, and if that hasn’t eased your fears, head back to the hospital.”
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4 Signs You Should Be Readmitted to the Hospital originally appeared on usnews.com
