An unexpected benefit: Reducing readmissions reduces mortality discharge-readmission

The success of American hospitals in improving discharge planning, partnering with post-acute providers and staying in contact with patients after they leave the hospital has led to an impressive reduction in avoidable readmissions. More impressive still: Hospitals that reduce readmissions the most are more likely to reduce mortality after hospitalization, according to a National Public Radio analysis by Kumar Dharmarajan and Harlan M. Krumholz. The writers took a deep dive into a study published in the Journal of the American Medical Association to determine if concerns that efforts to encourage hospitals to cut readmissions would have the undesirable effect of discouraging some from readmitting individuals who needed inpatient care. Happily, what they found instead is that engaging patients and families in the discharge process and better coordinating care from hospital to home reduced the chances the patients will need to return and also reduced the risk of death. “These better outcomes came not from new medicines or devices, but from a willingness of hospitals and health care professionals to engage with patients and families to promote truly patient-centered, high-quality care,” Dharmarajan and Krumholz report.

Is the one universal truth about medicine really this basic? communication-doctors-medicine

Suneel Dhand, M.D., who has practiced medicine on four continents, including up and down the eastern U.S., contends in MedPage Today that one health care rule applies across the globe: “Good communication is at the core of all good medical care, no matter where you live.” He lists three areas in which effective communication is critical.

• If physicians don’t know how to talk with patients in a meaningful way, they are lousy practitioners no matter how terrific their clinical skills may be.

• In today’s complex health care environment, leaders need to work as collaboratively and openly as possible with their staffs. And leaders need to understand the debilitating effect poor choice of words and tone can have on their operations.

• Different specialists need to talk with each other when treating the same patient or, Dhand writes, “everything ends up confused and muddled (most of all for the patients and their families.).” Along those same lines, health care facilities must communicate actively and clearly with each other during transitions of care. “Health care is a unique field. It is emotional and personal,” according to Dhand, adding, “It’s a field where communication is literally everything.”

Do you agree?

This may be our bodies’ ‘most compassionate gift’ lucidity

“With the exception of the minority of people who suffer sudden death, the majority of us experience a slumberous slippage from life,” writes Sara Manning Peskin, M.D., in the New York Times. Every major organ has the capability of shutting down the brain, which makes dying gentler than it otherwise would be. “The human body’s most compassionate gift is the interdependence of its parts,” Peskin asserts. She also decribes the fascinating phenomenon called “terminal lucidity,” in which some people emerge from the fog of disease and medicines for brief moments of lucidity and energy shortly before they die. “Like death itself, terminal lucidity retains a screen of mystery,” Peskin notes.