I HOPE I’LL BE TALKING ABOUTREADMISSION…

HI MY NAME IS TANIA P (FANCY VERSION: ADETANIA PRAMANIK)

I HAVE NO CLUE!!

SERIOUSLY….NO CLUE

YOU’LL HELP ME, YES?

READMISSION

PREVENTABLE READMISSION, some of the causes:

PROVIDER:• Early discharge• Inadequate quality of care• Lack of information to the

patient @ discharge• Lack of coordination care

and communication among providers, etc

PATIENT:• Not changing bad lifestyle• Not taking medication

regularly• Not understanding the

discharge instructions• Lack social support, etc

HF READMISSION

• #1 Condition for readmission (hosp charges ± 250 millions)

HF

READMISSION PREVENTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

YOU AS HF PATIENT:DISCHARGE INSTRUCTION

STAGES FOR DELIVERING INFORMATION

Exercise

Smoking Prevention

Nutrition Diet

Medications

Follow-up Appoinments

Weight Monitoring

When Condition worse

DISCHARGE

TRANSITION

R.I.P.

PROBLEM

How to deliver understandable information/knowledge about health-failure recovery practice in order to get the patients engage actively

Exercise

Smoking Prevention

Nutrition Diet

Medications

Follow-up Appoinments

Weight Monitoring

When Condition worse

Primary Care team

Hospital Clinical team

Family

Patients

DISCHARGE

TRANSITION

R.I.P.

CONTINOUS INFORMATION DELIVERY

Exercise

Smoking Prevention

Nutrition Diet

Medications

Follow-up Appoinments

Weight Monitoring

When Condition worse

Primary Care team

Hospital Clinical team

Family

Patients

DISCHARGE

TRANSITION

R.I.P.

CONTINOUS INFORMATION DELIVERYMethods of delivery:BrochuresDischarge summaryDevice therapy (telemonitoring)Home visitsPhone call etc

Exercise

Smoking Prevention

Nutrition Diet

Medications

Follow-up Appoinments

Weight Monitoring

When Condition worse

Primary Care team

Hospital Clinical team

Family

Patients

DISCHARGE

TRANSITION

R.I.P.

CONTINOUS INFORMATION DELIVERYOther Considerations:Class of HFAgeCognitive abilityEducationetc