Stories about: family centered care

Are pediatric patients being discharged before they’re ready?

Parents' perceptions of their child's health are a good predictor of hospital readmission.Because unplanned hospital readmissions put patients at risk, burden families and add to the cost of health care, many medical professionals are taking steps to reduce them. To push the effort, new Centers for Medicare & Medicaid Services (CMS) rules impose escalating penalties that decrease a hospital’s Medicare payments if patients are readmitted within 30 days of discharge.

Last week on Vector, we reported research suggesting that some readmissions may be incorrectly classified as preventable (and thereby penalized), particularly at pediatric hospitals. But what steps can be taken to reduce the number of truly preventable readmissions?

One step, highlighted here last week, is making post-discharge communications much simpler with texts and emails. But how can hospitals make sure their patients are ready to go home? A new study published in the International Journal for Quality in Health Care finds that in pediatric settings, the answers may be found in parents’ perceptions, which turn out to be good predictors of an unplanned readmission.

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Hospital rounds: How’s the doctor-patient communication system?

(Andreas Gohr/Flickr)

When patients are sick enough to require hospitalization, medical decisions often involve nontrivial tradeoffs between risks and benefits. They require discussions with patients and families from a variety of cultures and backgrounds. And sometimes these discussions break down.

Patient-clinician communication is increasingly recognized as an integral part of clinician competency. Indeed, family-centered rounding, increasingly practiced at Children’s Hospital Boston, is a critical step in this direction. Fully adopting this practice surely will enhance communication quality.

Yet, I suspect we’re still missing cues from patients and families, signs that our alliances with them are not sound. We can’t be maximally perceptive all of the time. It is busy, we are tired, we want to teach, we want to be efficient, and we want to get to the noon conference to learn to be better doctors.

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