It’s probably safe to say that anyone who’s been admitted to the hospital is eager to go home as soon as possible, but an early discharge from a hospital can cause as much damage as any other form of medical negligence.
There are many factors that go into deciding when a patient is ready to be released from care, and If a patient is discharged from the hospital too early, physicians will not be able to respond to emergent issues that may arise as a result. Understanding what these factors are and how they may affect your recovery is crucial when advocating for your health.
What should happen during the discharge process?
Before leaving the hospital a patient must go through the discharge process. This means a physician will evaluate the overall health of the patient and discuss findings with everyone involved in their continuing care and rehabilitation. This includes communicating specific details and information outlined in the formal process.
During the discharge process, the patient must be given:
- Information on when to schedule a follow up appointment and with whom.
- A healthcare team contact who can be reached with any follow up questions or concerns.
- Instructions on how to take medications and proper dosage.
- A plan to move to a rehabilitation or care facility, or back home, for recovery.
- Information on how to use any aids, equipment, or support services that may be needed.
Signs that a patient is not ready to be discharged
Any abnormal vital sign such as temperature, heart rate, respiratory rate, blood pressure, or oxygen level can be a sign that a patient should not be discharged, yet about 1 in 5 patients with abnormalities will be discharged anyways. Before being discharged, a patient should ask the doctor to verify that all vital signs are stable.
Having one vital sign that’s not stable, an abnormal respiratory rate for example, increases risk of readmission or death by 36 percent compared to fully stable patients. Having three unstable signs quadruples the likelihood of readmission.
There are other signs that may indicate the patient is not ready to return home, including not feeling ready to leave because their home is not functionally set up for their medical needs to not being mobile and needing full-time care.
Why are patients still getting discharged?
The decision to discharge a patient from a hospital is an important one that should not come with trade-offs. However, many medical and non-medical factors are often taken into account, while the actual reasons for discharge frequently remain largely undefined and can be considered a matter of “risk assessment”.
For example, a more emergent patient may be prioritized over another more stable patient if there are not enough beds or other resources available. This can mean the more stable patient must be discharged, even if not fully ready to depart hospital care. It is also possible for responsibility to be deferred in these instances. If a patient is stable enough, and there are other perceived pressing matters, the patient may be asked to follow up with their general practitioner, instead of getting more time with hospital staff.
In a perfect world, all patients needing ongoing medical assistance would be kept for further observation and care, but in a world with limited resources and bureaucratic processes, this is not always the case.
When is a physician considered negligent?
Not following the discharge process or having to take short cuts due to lack of resources can lead to grave mistakes and result in harm or death for a patient. Physicians and medical staff are responsible for the care of their patients, and the decision to discharge is no exception – it must be weighed with intention and the outlined process must be followed.
Whether a patient is not informed of when they need to schedule a follow up appointment and with whom or they have compromised vital signs and are not medically stable, the risks associated with early discharge are significant. It is because of the seriousness of this issue that healthcare professionals can be found liable for medical malpractice.
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