Readmissions May be Triggered by 'Post-Hospital Syndrome'

Cheryl Clark, for HealthLeaders Media , January 15, 2013

Krumholz gives special consideration to the cognitive deficits and information overload that can result from the confusion of hospitalization, and sometimes result in delirium.

Medications such as sedatives can be overprescribed, causing a dulling of the senses and impair judgment, or under prescribed, causing pain hypercatabolism, immunosuppression, hypercoagulability and increased nervous system activity.

He called on hospitals and doctors to "solicit details far beyond those related to the initial illness" and be aware of "functional disabilities, both cognitive and physical," to appropriately align care and support after hospitalization.

A good place to start, he suggests, is for hospital teams to reduce the causes of these disruptions where they occur, such as helping patients get better sleep and minimize pain and stress while they are hospitalized, and promote better nutrition.

They should also "optimize the use of sedatives, promoting practices that reduce the risk of delirium and confusion, emphasizing physical activity and strength maintenance or improvement, and enhancing cognitive and physical function."

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4 comments on "Readmissions May be Triggered by 'Post-Hospital Syndrome'"

Mary Mammarella (1/18/2013 at 12:31 PM)
This reminded me of an article I read some years ago about physicians who treated people who had been tortured and were trying to recover. I am NOT accusing anyone of torture, but rather suggesting there might be something to learn from those physicians. When you look at the items sited like sleep deprivation, nutrition, pain, etc., it is hard not to connect the patient's reaction to hospitalization to the reactions of released prisoners or victims of torture. Thanks for the article.

Sharon Del Favero (1/16/2013 at 1:18 PM)
A very good argument for a holistic approach to patient care which currently contradicts the "focus only on the admitting diagnosis". While methods of reimbursement see this focus as less costly I would challenge is it really in the big picture? each disease state impacts another if present within the same patient..... does it not?

debra reynolds (1/16/2013 at 11:37 AM)
Sleep deprivation, and feeling alone and out of control of your circumstances can be scary for patients. Healing happens when a patient is at at peace. Explain to the patients in their language and their pace the procedures, lag-times etc. Use volunteers to keep them company in their rooms, if they want one. A little courtesy can go a long way towards recovery.




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