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Reducing Hospital Readmission Rates: Effective Transitional Care

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Disclaimer: This Inside South Florida segment is sponsored by WellMed and Optum. All opinions and views are of the advertiser and does not reflect the same of WSFL-TV.

Each year, millions of Americans are readmitted to the hospital within 30 days of discharge. According to the Agency for Healthcare Research and Quality, effective transitional care can lead to better health outcomes and help avoid a return visit to the ER. Family Medicine Specialist Dr. Francisco Solis from Optum joined Inside South Florida to discuss strategies for reducing hospital readmission rates and keeping patients healthy at home.

"One in every six Medicare patients is readmitted to the hospital within the first 30 days of discharge," Dr. Solis explains. "The reason is that there are a lot of complications that happen once you're discharged. This is why we're here to discuss transitional visits, which are the visits scheduled after discharge."

Effective transitional care is key to reducing readmissions. "We advise or educate our patients to have a transitional visit seven days after admission," says Dr. Solis. "Once they know they're going to get out, either from the emergency room, urgent care, or hospitalization, they should call the clinic to make their first appointment."

During these transitional visits, several important topics are covered:

  • Reason for Hospitalization: Discuss why the patient was admitted to the hospital.
  • Medication Review: Go over the medications prescribed at discharge.
  • Results and Diagnostics: Review any diagnostic tests done in the hospital.
  • Home Support: Assess if the patient needs help at home.

Dr. Solis emphasizes the importance of communication in preventing readmissions. "Step one is to call the office and make the appointment. At Optum and WellMed, we always give priority to patients that are in the hospital to prevent readmissions."
He offers additional tips for these appointments:

  • Bring Discharge Papers: Ensure you have all paperwork given to you at discharge.
  • Medication List: Bring all medications you are taking.
  • Support System: Bring a family member or loved one to the appointment.
  • Questions and Concerns: Write down any questions you have for your doctor.

Dr. Solis adds that discussing the reason for hospitalization and planning follow-up care can help prevent readmissions. "If you need further appointments, if you need to be seen with a with a specialist, or if you need help at home as well."
For more information on effective transitional care and reducing hospital readmissions, Dr. Solis recommends visiting agehealthytoday.com.

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