Setting Health Care Goals with Your Physician

Research suggests that when patients participate in the goal setting process, they are more likely to achieve positive changes in their health status. Health care goals can be long-term or short-term, complex or simple. What are your health goals? Use the following suggestions to help you set and achieve your personal health care goals.

Establish Goals with Your Physician

Goals should be made with your physician following a discussion of pertinent diagnosis and treatment recommendations. Once an agreed upon goal is decided, you can review a plan of action necessary to reach that goal. This approach will demand an increased involvement in your own care.

For example, if you and your physician decide to set a health goal of lowering your blood pressure, establish a timetable for its accomplishment. Action steps would be mutually reviewed between you and your physician. Your strategies may include a combination of medication, nutrition, education and exercise. The physician becomes your collaborator and advocate in these goal-setting interactions. A much closer physician-patient relationship will result in this goal-oriented approach.

Effective Goal Setting

Successful teamwork with your physician is essential in the goal setting process. Allow your physician to assist you achieve your goal by providing education, recommendations and encouragement. The most effective health care goals are:

o Specific
o Measurable
o Attainable

It is important to review your goals with your physician during each visit. Document your progress in a medical organizer. You can then adjust your goals as needed and seek additional information and support.

Appropriately set health care goals will help you reach your maximum health potential. Action will occur only if the goal is meaningful to you. Believing in your ability to reach your goal and a daily commitment to achieving it is critical to your overall health.


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Improving Hospital Discharge Safety With Effective Communication

According to an article in Society of Hospital Medicine, nearly (49%), of patients released from a hospital will experience at least one medical error related to follow-up care. The article suggested that the majority of the errors were related to a breakdown in communication between the “in-hospital team” and the patient’s primary care physician.

Many hospitals today employ “hospitalists” to provide care for their patients instead of having a primary care physician direct the care. As a result, your physician may have very little knowledge of your hospital stay. Because of this, you will want to do everything in your power to be sure that effective communication is part of your hospital discharge plan.

Critical Transition Period

The hospital discharge is considered a transition period. During this time, the responsibility of your care is being transferred from your hospital based providers to your primary care physician. This is a very critical time as many patients are vulnerable to errors if effective communication is not present.

Important information about your hospital stay e.g., discharge medication, test results (completed, pending and planned), and new diagnosis needs to be relayed to your primary care physician.

Communication Is a Challenge

The standard form of communication between the hospital care team and the primary care physician is the discharge summary. Unfortunately, the discharge summary is rarely available during the first follow-up visit (12-34%) and it often lacks important details of the hospitalization.

In fact, as many as 61% of physicians are unaware of test results that may change the course of your care following discharge. This fragmentation of care is very dangerous and may lead directly to a medical error, readmission to the hospital or substandard care.

Ask Your Hospital Team to Contact Your Primary Care Physician

The quality of your care, following the hospital discharge, will be dependent upon the quality of the communication between your hospital team and your primary care physician. In an ideal world, your physician would have direct contact with the hospitalist to exchange information and discuss your plan of care.

Because of this, you need to do everything in your power to make sure this communication takes place. Complete the form below and then give it to your hospitalist. This will help ensure a safe and secure transition home from the hospital.

Dear Dr. __________________________

Please call my primary care physician, Dr. __________________at #______________________

to discuss my condition and treatment recommendations.

Thank you!


Remember, the quality of your health care is dependent upon the quality of communication that occurs between your providers of care.



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Hospital Success: Get to Know Your Medical Team

One of the most important keys to a successful hospital outcome is your ability to work effectively with your medical team. To receive the best health care possible, you must establish a “partnership” with your physician and other members of your health care team.

Studies tell us that patients, who communicate effectively with their physician, actually recover more quickly from an illness. Research also suggests that patients who take a more active role in visits with their physician may have a greater sense of control and better health outcomes.

Identify Your Medical Team

Following your admission to a hospital, you will begin to meet various members of your medical team. This may consist of several physicians, nurses, dietician, pharmacist, therapists and case manager. Embrace the process of relationship building.

Partnership with your medical team is a key component to your recovery. You must invest the time and energy teaching your team members what you want, expect and need. By doing so, you are telling the medical community you want to be an active member of your own interdisciplinary team.

Review Plan of Care with Medical Team

Once you have met with all members of your care team, it will be important to carefully review your plan of care which each discipline. A patient plan of care provides a roadmap to guide your medical team. A care plan is developed to ensure you receive appropriate treatment and have a positive outcome.

Remember, you can’t hit a target you can’t see. Be sure to discuss your care plan and goals with each member of your health care team. Each and every time you communicate with your team, you will promote care coordination. This team approach will help avoid fragmentation of care and keep everyone focused on your individual plan of care.

Remain Involved in Your Hospital Discharge Plan

A very important element of your patient plan of care that is essential to a successful outcome involves each and every member of your health care team. This element is known as your discharge plan. Your discharge from the hospital must be professionally planned and organized for you to have a successful outcome.

Seek clear information about your discharge from each member of your medical team. It’s been shown, that patients who received detailed, discharge instructions, are 30% less likely to be readmitted to the hospital or visit the emergency room than uniformed patients.

Getting to know and partner with your medical team will set the tone of all of your hospital medical encounters. Your goal should be to develop a bond with your medical team who will in turn become much more vested in your success.

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How to Avoid Hospital Acquired Infections


The Health Care Encounter

“Don’t touch me!” That’s probably what George should have said to his doctor but he didn’t. Most patients don’t. I was in George’s room to assist with the completion of a health care power of attorney document. George was in isolation due to an infection. Anyone could tell he was in isolation as a result of the “big” sign outside of his room that alerted all those who entered of the proper precautions. The precautions included putting on a hospital gown and wearing protective gloves.

The gloves and hospital gown that I had on did not interfere with my conversation with George. What stopped us was George’s physician who came into the room to join the conversation without his gloves or gown. George’s doctor preceded to touch everything including the patient, bedrail and my nerve!

Yes, I understand that physicians can be very busy. The problem is that bacteria and germs do not care who they attach themselves to. My thought immediately turned to “who” was the unsuspecting patient he would see next?

Health Care Consumers at Risk

“Gowning and gloving” as they call it in the hospital is time consuming but essential to stop the spread of infection. Health care acquired infections kill as many as 90,000 people annually in the United States, according to the Centers for Disease Control and Prevention. Another 1.9 million people nationwide who develop such infections endure longer stays in the hospital. Approximately 5 to 10 percent of all hospital patients develop infections.

More Americans die each year from hospital acquired infections than from auto accidents and homicides combined. Even though the problem is well documented, the risks of getting a hospital infection have steadily increased.

The good news is that health care facilities can reduce infection rates significantly by proper implementation of infection control practices, especially hand washing. Unfortunately, many hospitals have not done so. According to the National Quality Forum, most studies report hand washing compliance rates that are generally less than 50 percent.

Safety Strategies

With these frightening statistics in mind, here are several action steps that an empowered health care consumer can do to decrease the likelihood of a hospital acquired infection.

o Use anti-bacterial wipes to clean the telephone, TV remote and bedrails. Studies show that many patients’ rooms are contaminated with MRSA (methicillin-resistant Staphylococcus aureus) and VRE (Vancomycin-resistant Enterococci).
o Request that all hospital staff wash their hands or use an alcohol-based hand sanitizer before touching you.
o Wash your hands frequently.
o Be sure that all intravenous tubes and catheters are inserted under sterile conditions.
o Choose a surgeon with a low infection rate.
o Ask your doctor if you need to take an antibiotic prior to surgery.

The Committee to Reduce Infection Deaths offers a comprehensive guide to reduce your risk of acquiring a hospital infection. Arm yourself with as much information as possible. Remember, prevention works, and don’t be afraid to say, “don’t touch me!”


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Personal Medical Journal – Take Charge of Your Health Care

Research suggests that patients who take a more active role in visits with their physician may have a greater sense of control and much better health outcomes.

Participation in your own health care can be dramatically increased through the use on a personal medical journal. Here are several additional benefits of using this powerful management tool.

  • Better Health Status – It has been observed that more effective gathering by patients, and more conversation by patients with their physician during office visits was related to better health status.
  • Avoiding Duplication of Tests – Keeping track of all tests and treatment history will save your time and money by avoiding duplication of tests and procedures. Repeating tests and procedures are not only costly but they can also expose you to potential medical errors.
  • Increased Partnership with Physician – A personal medical journal will be your personal tool to effectively enter into a full partnership with your physician and many other health care professionals. A good partnership with your doctor begins with open communication. Keeping a complete and accurate record of your history will strengthen communication with your physician as you can provide them with useful information.
  • Become Empowered – Information is the key to patient empowerment. As you gather information about your condition you will become more informed about treatment options. This will allow you to manage your condition more effectively and increase your sense of well being. You will then become empowered rather than victim to your condition.
  • Improve Chance of Correct Diagnosis – According to the American Society of Internal Medicine, 70% of a correct diagnosis depends on what the patient tells the doctor. The use of a personal medical journal will help you share vital information with your physician about your symptoms. Having more data available will help your physician make better decisions. With this information-rich data at hand you may be able to provide your treatment team with the one crucial item of information that helps secure a correct diagnosis.

Take charge of your own health care with the use a personal medical journal. This will allow you to “collect and share” valuable health information with all of your providers. Use this powerful tool to help you get the best of what our health care system has to offer.

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Hospital Discharge – How to Plan For a Safe Discharge

Be aware that all unplanned, rushed or poorly coordinated discharges from hospitals are very dangerous!  A recent study in the New England Journal of Medicine concluded that one in five Medicare patients are readmitted to the hospital within 30 days. One in three are back within 90 days. The author suggests that many of these problems are related to inadequate coordination of care and poor discharge planning.

Why This Happens  

Discharge planning is not always given the care and attention necessary for a smooth transition from the hospital. All patients should receive detailed care instructions in their language and at their health care literacy level. Unfortunately, this does not always happen.

Hospital staff members are under intense pressure to release you as soon as they can. Those in the health care industry have coined the term “quicker and sicker” when they describe how patients are now discharged from hospitals. As a direct result of such early hospital discharges:

  • 41% of patients are discharged with test results still pending.
  • 13% of these tests are of an urgent nature.

What’s worse, at the time of discharge, one half of adults have trouble understanding their prescriptions or discharge instructions. In addition, less than one-half of patients know their diagnosis, treatment plan or side effects of prescribed medication.

The results of poor care coordination at the time of a hospital discharge can jeopardize your health and safety.  Here is my recommendation; don’t allow this to happen to you or a loved one.

Take Active Role in Your Discharge Plan

You must insist on a well planned and coordinated hospital discharge plan. At the very least, be sure to:

  1. Receive the necessary discharge education about the condition that brought you to the hospital. Take full advantage of the expertise of the hospital staff. Ask as many questions as necessary to gain a full understanding of your condition, diagnosis, and treatment plan. Ask for written information as well.
  2. Request to meet with the hospital pharmacist to review all of your discharge medications.  Be sure to discuss any changes, additions or deletions of medication that you were taking before your hospitalization. This process is called “Medication Reconciliation” and is essential to a safe discharge. It has been found that between 20 and 30% of all hospital readmissions within 30 days are the direct result of medication issues.
  3. Find out when you need to follow up with your medical team such as your primary care physician, surgeon or specialist. This is critical as a well coordinated discharge plan will involve timely follow up care.
  4. Be sure that your primary care physician receives copies of your discharge medication list and instructions. Take your copy with you to your follow up appointment.

These are just a few of the items that need to be contained in your official discharge plan. Remember, this may not happen unless you request it. You will increase the likelihood of a safe discharge when you are an active participant in discharge planning.

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