Benjamin R. Cohen, MD, FAANS, FACS, a spine surgeon with Neurological Surgery in Lake Success, N.Y., discusses four ways spine surgeons can help prevent readmissions.1. Communicate expectations to patients. Spend time discussing with patients what they should expect when they return home to put them at ease. "The main thing we can do to prevent readmissions is provide better communication with patients," says Dr. Cohen. "Really sit down with them for 10 to 15 minutes in their room before they leave the hospital. Go over what they should expect and have a family member present as well."
Treat non-surgical patients similarly before discharging them for back pain so they understand their diagnosis and treatment options. "They should have a clear understanding of when the follow-up visit is scheduled and what to do if their condition worsens," says Dr. Cohen. "They need to know the situation and how to reach you if necessary."
2. Provide patients with discharge instruction sheets. Dr. Cohen gives each patient a discharge instruction sheet he acquired during his fellowship that includes general information, activities to avoid and what problems are serious after surgery.
"This information tells them what they can expect as normal and what they should call my office about," says Dr. Cohen. Patients can refer to the instruction sheets at home if they forget verbal instructions from pre-discharge conversations.
3. Make a midlevel practitioner available to answer questions. When patients experience minor complications after surgery, such as issues swallowing or spasms, they might unnecessarily go to the emergency room for help. However, if you connect them with a midlevel provider instead, they could call that person to assess whether an ER visit is necessary.
"It's helpful to have a nurse practitioner or physician's assistant to help when patients have questions," says Dr. Cohen. "When patients get readmitted, assuming it's not an emergency, it's often because they don't know what else to do. If you have an option for them to call your office during the day and reach a nurse, the problem can be solved over the phone."
4. Build a flexible schedule to address simple issues quickly. If the patient does have an issue that requires additional care, make sure they know you'll attend to them right away. Direct patients to call your office and discuss the issue, such as an infection or drainage in the wound, and your staff can schedule an appointment for them as soon as possible.
"If you have them come into the office instead of the ER, you can take care of it," says Dr. Cohen. "Communication and a clear understanding of your services are important, and you have to be available outside the hospital."
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