Have you ever felt that you or a loved one was getting pushed out the door of a hospital?
The standard of care requires that patients shouldn’t be discharged from the hospital if they’re unstable or there will likely be material deterioration in health status after discharge.
Yet, as a former hospital administrator, I’ve realized that there are more and more pressures being put on hospital leaders, doctors, and nurses to send patients home as soon as possible. Sadly, these factors aren’t really about patient safety but are more about insurance, Medicare, and Medicaid requirements.
Hospitals are so discharge-focused now that the standard of care requires the nursing staff to start planning for discharge on the very first day that patients are admitted.
In a case that we’re working on now, things started out okay but ended tragically.
It started with a woman being admitted to a Kingwood, Texas hospital on a December day for surgery involving her heart and lungs. Case managers and registered nurses got right on the discharge planning. Two different doctors chimed in, noting that the woman would need home health and home oxygen once she was discharged.
Throughout her hospitalization, which lasted a few weeks, she received supplemental oxygen because she was having a hard time breathing and maintaining good oxygen saturation levels without it.
As Christmas approached, the health care team decided it was time for this woman to go home. On the morning of her discharge date, her cardiologist wrote an order to case management that she needed home health nursing and home oxygen. Within a half an hour, the case manager faxed a request to a nearby vendor.
And then the ball was dropped.
The vendor didn’t respond. The case manager didn’t speak up. No one told the doctor. A registered nurse finishing discharging the patient like nothing was wrong.
The patient’s husband took her home, where there was no home health or home oxygen. When she started having problems breathing, the husband called the hospital for help, but it was Christmastime. The outside vendors weren’t responding, and the hospital staff didn’t do anything about it.
Within days, the woman collapsed. There was a 911 call. She ended up back at the same Kingwood hospital. This time, her diagnosis was dire—anoxic encephalopathy, a brain injury caused when a person stops breathing. It wasn’t long until she was dead.
Our nursing and medical experts agree that this woman should’ve never been discharged home without home health and home oxygen lined up. If the case manager and nurses had just followed the doctor’s order, this needless death could’ve been avoided.
What you can do
If you’re in a situation where you or a loved one are being pressured into discharge from a hospital, make sure that you’re crystal-clear on any help or equipment that will be needed at home. Ask if it’s safe to be discharged. Ask for details on the vendor information, when they’re going to show up, and what they’re supposed to do. Ask what do if the home health or durable medical equipment (DME) doesn’t show up.
By Texas law and Board of Nursing rules and regulations, Texas nurses have a duty to advocate on behalf of their patients. Advocacy means speaking up to make sure that there’s proper health care and that a patient isn’t put into danger. It means talking to the doctor to get appropriate orders to protect the patient. It means going up the chain of command if the doctor won’t listen.
If you or someone you care for has been seriously injured because of being prematurely discharged from the hospital, then contact a top-rated skilled Houston, Texas medical malpractice lawyer for help in evaluating your potential case.