What you need to know to help you get better after you leave the hospital.
Discharge instructions, sometimes called an after-visit summary, are a statement of important information you need to know to help you with self-care after you leave a hospital.
While you are leaving the hospital, you very well may not be completely healthy. You may have had surgery, delivered your baby, had a heart attack, or have long-term health problems.
You need these medical instructions to help you recover. Sometimes they can help you stay healthy after you recover. You will receive discharge instructions whether you are going home or being transferred to another healthcare facility, such as a rehabilitation center or nursing home.
Someone from your healthcare team should discuss your discharge instructions with you – before you leave the hospital – to make sure you understand them. Make sure you ask about anything you don’t understand. If no one talks to you about what to do after you leave the hospital, politely ask someone from your healthcare team to explain your discharge instructions. You’ll have a hard time getting better if you don’t know how care for yourself.
Instructions will include information about:
- The care you received in the hospital
- Why you were admitted and your diagnosis
- The results of tests and surgeries or procedures you had in the hospital
- Any tests you need after you leave the hospital
- Special instructions to help you get better at home
- Referrals for additional care outside the hospital
- Follow-up appointments with your doctor
- A list of medications you may need, including the dosage and how often to take them
- A list of potential side effects of these medicines
- Restrictions on activity, if you need them
- The diet you should follow
- How much, and which, fluids you might need
- How to care for any wounds (such as surgical incisions), and how to know if the wounds are becoming infected
- When you should call your doctor or go back to the hospital
The document may also tell you what lifestyle changes you might need to make to prevent more health problems. For example, if you’re leaving the hospital after a heart attack, your discharge instructions will probably discuss quitting smoking (if you smoke) and getting your blood pressure under control.
It’s important to know that following these instructions helps a hospital keep their rates of readmission low. Readmission is when you have to return to the hospital shortly after you left.
People often return to the hospital because they don’t follow their discharge instructions, or they don’t understand them in the first place. Even more often, patients have an adverse drug event – any injury that results from taking medicines, taking medicines without following instructions, or forgeting to take your medicines altogether. Adverse drug events can cause physical harm, mental harm, or loss of function. People sometimes have to go back to the hospital because their surgical incisions get infected – a major reason to follow care instructions.
The Centers for Medicare and Medicaid Services, which reimburse hospitals for part of the cost of your care, fines hospitals for having too many patients return.
February 24, 2020
Christopher Nystuen, MD, MBA