Elderly patients are some of the most susceptible to adverse surgery outcomes and related infections. When those issues arise after the patient has already been discharged, it’s best for the patient to return to the same care center where the operation was conducted, according to a new study published by the Journal American Medical Association Surgery.
Researchers with Harvard School of Public Health teamed up with Brigham and Women’s Hospital in Boston to conduct the study, which examined outcomes for more than 93,000 elderly patients who were re-hospitalized after some type of major or invasive surgery between early 2009 and late 2011.
Of those, one in four was readmitted to a hospital or care center different from where the surgery was performed. Those individuals were at far greater risk of death.
Our Naples medical malpractice lawyers understand the most common surgeries involved were:
- Pulmonary lobectomy (removal of diseased lung tissue)
- Coronary artery bypass grafting (improving blood flow to the heart)
- Colectomy (taking out abnormal colon tissue)
- Abdominal aortic aneurysm repair (for major blood vessel strengthening)
- Hip replacement.
Researchers adjusted for a host of variables, including the type of hospital involved and the distance patients lived from the hospitals, those who received “fragmented care,” that is, post-surgical treatment from somewhere other than where they had the surgery, where more likely to suffer fatal results within 30 days than those who were treated at the same hospital. Those treated at the same hospital had a mortality rate of 4.1 percent, while those treated at different facilities had a mortality rate of 5.8 percent. Put another way, this is a difference of more than 40 percent.
What this tells us is two things: First, there is a major problem with patients being released before they should be, or at least who are not receiving the appropriate level of follow-up care. If they were, they would not require a 2 a.m. ambulance ride to a facility where staff may not be trained in that specialty or, at the very least, isn’t familiar with patient’s condition.
Secondly, care providers need to plan better for when these types of contingencies are necessary. In some cases, they may not be feeling well and are instructed by care centers to go to the nearest emergency department. But that center may not be the best-equipped to handle their care. Similarly, patients who call 911 are taken to the nearest hospital by emergency medical services workers who are simply trying to get them to a facility as fast as they can.
Study authors say a patient should never be discharged from the hospital without a scheduled follow-up, as well as clear instructions on potential complications and where they should go or who they should call in the event of an emergency.
Too many doctors view patient discharges effectively as a “hand-off.” That is, once the person is discharged, they are no longer under that doctor’s responsibility. This is problematic, particularly where major surgery is concerned.
Researchers also called for enhanced efforts to achieve clinical integration – that is, the facilitation of coordinated patient care across conditions, providers, settings and time to achieve the best possible outcomes.
If you have been injured, contact the Hollander Law Firm at 888-751-7777 for a free and confidential consultation. There is no fee unless we win.
Problems after surgery? Go back to same hospital, study says, Dec. 8, 2014, By Lisa Rapaport, Reuters
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