Top Tips for a Successful Hospital Stay

Going to the hospital is certainly not something anyone generally plans on or looks forward to; however, if the time arrives when you do have to stay at a hospital for any length of time, there are definitely things you can do to make that stay less stressful and your recovery as successful as possible.

1.       Reduce your stress by working with your insurance company ahead of time to let them know what    procedures/tests you’re going for and determine what is covered and/or pre-approved.

2.       Make sure you’ve notified business associates and family/friends about how long you’ll be absent, what obligations you’ll be unable to fulfill, and what your desires are for visitors during your stay.

3.        Have required documentation and forms with you when checking in.  This includes:

a.       Personal photo ID

b.      Health insurance cards

c.       List of medications (prescription and non-prescription)

d.      List of supplements (including herbs and vitamins)

e.      Health Proxy forms and Advance Directives

4.       Bring personal grooming items and cases for such things as glasses, hearing aids, and dentures.

5.       Get to know the nursing staff and aids taking care of you; forming a rapport with these professionals can only benefit you in the long run with your care and progress.

6.       Remember that you are the one in control of your treatment decisions.  It’s fine to ask for a second opinion, if you feel it’s warranted.  If you’re not comfortable with any treatments or procedures, do your due diligence before deciding to refuse the treatment.

7.       Be your own advocate or have someone with you who can be, if you’re indisposed; make sure everyone is informed.

8.       Be knowledgeable…don’t strictly rely on information given to you by others; know enough to ask good and appropriate questions…and don’t be afraid to ask them.  Know your patient rights.

9.       Communication (as always) is key, as in any “relationship”.  Ask questions…find out who you can ask questions of when you have them;  ask about your tests or procedure…what it will feel like, if there are risks and if so, are there alternatives.

10.   Continue communicating as you are getting ready to be discharged.  Know:

a.        How long your recovery should be

b.       The kind of care you will need

c.        What medication you’ll need to continue taking and which to stop

d.       Signs that your recovery isn’t progressing and when you need to see the doctor

e.       Resources for help you may need and/or medical equipment necessary for recovery

11.   Most importantly, keep a positive attitude and outlook for a healthy outcome!

Health-Related Definitions Important to Patient Advocacy

In our last blog, we discussed health care reform and the recently passed Patient Protection and Affordable Care Act.  The NTOCC (National Transitions of Care Coalition) and the CMSA (Case Management Society of America) worked diligently to positively affect the outcome of health care reform, most specifically in the area of transitions of care.

While transitions of care is one of the most critical aspects of case management that can improve patient care and well being, while also keeping a handle on costs, one of the other important elements of patient recovery that should be encouraged and supported is patient advocacy.  Helping patients learn about and understand their disease, as well as how to speak up for themselves while hospitalized or when transitioning to rehab and/or home, is crucial.

In order to accomplish this, a basic requirement is that patients know and understand terminology that is used during their hospital stay, in regards to their treatment, and throughout their transition to a new location and level of care.

There is a great amount of very helpful information and tools on the NTOCC website that can make a patient’s course of treatment and doctor visits flow much easier and increase the benefits that can be realized.  To help along the way, here are definitions taken from the NTOCC site (as well as the toolkit) that will, hopefully, dispel some confusion for patients and their caregivers, which should, in turn, help them to be more knowledgeable advocates for themselves during their treatment program and after.

ADVANCE DIRECTIVE – A legal document that tells your choices about the health care you would or would not want if you became unable to decide for yourself. An advance directive comes in two forms:  Power of Attorney for Health Care and Living Will.

ACUTE ILLNESS – Illness or injury that lasts a short time.

CASE MANAGER – Case managers work with people to get the health care and other community services they need, when they need them, and for the best value.

CHRONIC ILLNESS – Illness that lasts a long time or throughout a person’s life. Chronic illnesses can be diagnosed in both children and adults and can often be managed with a variety of treatments.

EVIDENCE-BASED MEDICINE (EBM)- Medical treatments which have been shown by high-quality, published research to have the best results. EBM is practiced by clinicians to give each patient the most effective care and treatment possible, based on national standards and up-to-date medical research.

HOSPITALIST – Doctor whose primary professional focus is the general medical care of hospitalized patients. Activities include patient care, teaching, research, and leadership related to hospital medicine.

MEDICAL ERROR – Any preventable event (such as a mistake related to medication, a mistake in diagnosing or treating a condition, or a problem with medical equipment) that may cause or lead to unintended outcome or patient harm.

NURSE PRACTITIONER – Registered nurses who are prepared, through advanced education and clinical training, to provide a wide range of preventive and acute health care services to individuals of all ages.

NPs take health histories and provide complete physical examinations; diagnose and treat many common acute and chronic problems; interpret laboratory results and X-rays; prescribe and manage medications and other therapies; provide health teaching and supportive counseling with an emphasis on prevention of illness and health maintenance; and refer patients to other health professionals as needed.

PAIN INTENSITY SCALE – A communication tool to help patients explain the pain they are experiencing using pictures or other standard terms.

PALLIATIVE CARE – Serious illnesses can cause physical symptoms, such as pain, nausea, or fatigue. You may also have psychological symptoms like depression or anxiety.  The treatments for your disease may cause symptoms or side effects. Palliative care relieves symptoms without curing your disease.

PATIENT ADVOCATE – A person who helps a patient work with others who have an effect on the patient’s health, including doctors, insurance companies, employers, case managers, and lawyers. A patient advocate helps resolve issues about health care, medical bills, and job discrimination related to a patient’s medical condition.

PATIENT AND FAMILY-CENTERED CARE – An innovative approach to health care that is grounded in effective partnerships among health care patients, families, and providers. Patient- and family-centered care applies to patients of all ages, and it may be practiced in any health care setting.

PHYSICIAN ASSISTANT – Health professionals who practice medicine as members of a team with their supervising physicians. PAs deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and prescribe medications.

Presenteeism and the Cost to Employers

As we’ve discussed in previous blog posts, case managers can have a very strong and positive impact on patients and/or parents of patients when transitioning care from a hospital or rehab setting to home.  Part of this impact comes in the form of education and support that helps reduce repeated visits to the ER or doctor’s office.  This same education and support can help to minimize “presenteeism” on the part of workers with sick children at home or who have chronic illnesses themselves.

Presenteeism, or the issue of workers being present on the job yet not productive, is a growing problem for employers and workers alike today.  More and more research is being done on the cost of presenteeism.  According to Walter Steward, Ph.D., M.P.H., director of the AdvancePCS Center for Work and Health,

“Most employers know there’s a link between health and productivity, but because the link has been difficult to quantify, they have chosen not to act.”

Information from the American Productivity Audit (APA) spearheaded by Dr. Steward, indicated that lost productive time (LPT) due to health-related issues costs US employers $225.8 billion per year.  It’s estimated that over 70% of that time is from lack of productivity while actually “present” on the job.  Six percent of that amount is from work absences related to family health matters, as in having to take time for children who are ill.

As continued research and studies are done in relation to the financial drain that presenteeism can cause, many are coming to the same conclusion…that it can have more of an impact on productivity than absenteeism or short-term disability.  One such conclusion is that presenteeism can be over seven times more costly than absenteeism, taking into consideration subsequent time off for worsening health issues.

Enter here the case manager!  An independent case manager, who can work closely with a family from the health care facility to the home, helps them gain the knowledge necessary for making improved healthy choices in their daily lives.  The case manager can educate parents of a sick child on what things to watch for and how to be an advocate for the child, as well as how to be proactive, rather than reactive.  Understanding the illness and feeling more in control can free up a parent’s mind when he and/or she has to get back to work, helping them to be more productive on the job.  Working with an adult patient (or a young patient who is returning to school) to understand his or her disease or illness in such a way as to stay on top of it as much as possible, enables them to take more preventive steps to stay well and avoid complications down the road or future admissions to the hospital.  Feeling confident about their health goes a long way toward preventing presenteeism AND absenteeism!

As stated by researcher Ron Goetzel, PhD, of the Cornell University Institute for Health and Productivity Studies,

“If a company’s health plan is poor, for example, disorders may not be well managed. Workers will continue to work and not be as productive.  Employers need to weigh the costs of good medical care against the potential for on-the-job productivity losses, which we see are substantial in many areas.”

In the long run, investing in case management services for employees as part of a healthcare insurance plan, can mean bottom-line savings when assessing the cost of presenteeism in any business.