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When we're unwell and at our most vulnerable, we place our trust in healthcare professionals. We count on their expertise, education, abilities, and empathy to guide us toward recovery, enabling us to resume our roles as employers, employees, partners, parents, neighbors, and friends.
It's the last thing we anticipate—leaving the hospital in worse condition than when we arrived. Yet, surprisingly, there are 10 ways a hospital stay might actually exacerbate our health issues.
10. Post-Hospital Syndrome
Dr. Harlan Krumholz from the Yale School of Medicine introduced the concept of 'post-hospital syndrome,' describing a vulnerable phase after hospitalization where patients face a higher risk of falling ill again. This often leads to readmission within 30 days after their initial discharge.
Readmissions can stem from various factors, including hospital-acquired infections (HAIs), the stress of being hospitalized, insufficient sleep, poor nutrition, lack of physical activity, weakened immunity, and depression. A 2009 study revealed that 20% of Medicare patients, totaling 2.6 million individuals, were readmitted within a month of being discharged.
9. Hospital Food Errors
According to a Pennsylvania Patient Safety Authority study, hospital staff made 285 meal-related errors between January 2009 and June 2014. Of these, 181 were linked to allergies, primarily due to errors in charting and miscommunication.
Eight incidents resulted in 'serious harm to patients.' In one instance, a patient allergic to seafood was mistakenly served fish, requiring an epinephrine injection, multiple intravenous medications, and transfer to an intensive-care unit for close monitoring.
Other patients who were required to fast were either provided meals or given food that did not align with their dietary restrictions. These mistakes occurred at various stages of the 'dietary process,' from meal ordering to delivery.
8. Food Denial
In a piece published in the online journal BMJ Quality and Safety, doctors from Johns Hopkins Hospital argue that fasting patients for eight hours before surgery is not only unnecessary but also potentially harmful. In some instances, patients might even wait days without food in anticipation of possible anesthesia for surgery.
Depriving patients of sleep and proper nutrition can weaken their immune systems. Half of all hospital patients experience inadequate nutrition, which can result in 'inflammation, muscle deterioration, and damage to organs.'
Dr. Martin Makary, a co-author of the article, labeled the eight-hour pre-surgery fasting rule as a 'myth.' He and his team noted that patients can safely drink a high-carbohydrate beverage two hours before surgery. Additionally, he suggests allowing patients to eat non-hospital food during their stay.
7. Infections
Unsterilized medical tools, improper surgical techniques, and excessive antibiotic use lead to HAIs caused by bacteria, fungi, and viruses. Consumer Reports evaluated hospitals on their infection rates tied to surgical sites, catheter or urinary tract infections, and bloodstream infections. Later, they included C. diff and two dangerous drug-resistant bacterial infections that spread easily and can be deadly.
The US Centers for Disease Control and Prevention reported that in 2011, nearly 650,000 patients contracted almost 722,000 HAIs. Every day, 200 hospitalized patients lose their lives to these infections.
Even renowned hospitals like Johns Hopkins in Baltimore, Mount Sinai in New York City, and Ronald Reagan UCLA Medical Center in Los Angeles experience high HAI rates. Implementing strict infection-control measures, reducing antibiotic use, and thorough cleaning of hospital rooms and equipment are proven strategies to curb or eliminate these infections.
In states with weak reporting laws, some hospitals 'upcode' HAIs by using misleading billing codes that are hard to trace. This allows them to evade federal penalties and avoid losing payments due to HAI occurrences.
A proposed solution is mandating hospitals to report all HAIs, including patient names, infection impacts, and root causes. The proposal also recommends expanding audits to include more hospitals.
6. Poor Care Of Elderly Patients
Elderly patients often receive substandard care compared to other groups, leading to their discharge in poorer physical and mental condition than when they arrived. Many are inadequately fed, lack sufficient physical activity, or are not provided proper pain management.
Frequently, obstacles like oxygen tanks or IV poles restrict elderly patients from leaving their beds. Additionally, doctors may perform unnecessary procedures or prescribe medications that are redundant or potentially harmful.
Elderly patients often lose sleep due to noisy hospital wards or frequent nighttime vital sign checks. Unlike younger patients, seniors struggle more to recover from such disruptions, as they are less resilient.
Certain hospitals isolate elderly patients, removing IV lines and motivating them to dine in communal areas. These hospitals emphasize preparing seniors to manage independently at home.
Unfortunately, enhanced care for the elderly is not a priority for most hospitals, as issues like memory loss or mobility challenges, unlike HAIs, do not result in government penalties. 'If you don’t measure it, you can’t fix it,' remarked Ken Covinsky, a physician and researcher at the University of California, San Francisco, Division of Geriatrics.
5. Reduced Care
To stay afloat in tough economic times, smaller hospitals frequently join larger healthcare networks. Often, the US government does not oversee these mergers or their impact on the quality of patient care.
The aim of these mergers might be to 'eliminate redundant services, secure better insurance deals, and share cost savings.' However, some services may be discontinued entirely, as decisions are driven more by profit or ideology than by patient needs.
Even when state governments exercise some oversight, their focus isn’t on maintaining or improving care. Many regulations governing patient services were established during a period of hospital expansion rather than consolidation. In some instances, service reductions are ideologically motivated, such as when religiously affiliated hospitals decline to offer abortions.
4. Poor Staff Hygiene
Poor staff hygiene can leave patients in worse condition after hospitalization. Doctors sometimes neglect to wash their hands as frequently as required. Nurses, who are expected to remind doctors and surgeons, often feel it’s not their role to 'monitor the doctors.'
Nurses expressed that they fear reprimands if they were to remind doctors. Additionally, doctors dislike being corrected by nurses, as it suggests they are unaware of basic hygiene practices.
To address poor staff hygiene, some websites now rate hospitals on patient safety. The federal government also provides an online database tracking patient outcomes.
3. ‘Never Events’ And Serious Untoward Incidents
'Never events'—incidents that should never occur—can worsen a patient's condition. These avoidable mistakes, like operating on the wrong body part or leaving surgical tools inside a patient, can cause severe harm or even death.
Additionally, serious untoward incidents (SUIs) can lead to patient inconvenience, injury, or fatalities. SUIs encompass patients injuring themselves from falls, doctors ignoring test results and necessitating further treatment, faulty equipment leading to unnecessary breast screenings for women, and dentists removing the wrong teeth.
Hospitals should promote reporting of 'unsafe clinical practices,' a spokesperson from Wrightington, Wigan and Leigh NHS Foundation Trust stated, '[and such reports must be investigated thoroughly.'
2. Sick Doctors
Doctors often feel compelled to work even when ill, endangering patients with compromised immune systems. A survey at the Children’s Hospital of Philadelphia, involving 280 doctors and other healthcare providers, revealed that 83% had worked while sick at least once in the past year.
Their symptoms included fever, diarrhea, and cold or flu-like signs. Many admitted they worked while sick to avoid disappointing colleagues or patients.
Peer pressure also played a role, as doctors faced criticism for taking sick leave. Similar surveys confirm that workplace expectations often force doctors to work despite being unwell.
1. Missing And Malfunctioning Equipment
Princess Margaret Hospital in Eastern St. Thomas, Jamaica, struggles with two major issues: equipment breakdowns and a shortage of essential tools. While a new ward and facility renovations aim to address these problems, challenges persist.
Staff members have privately reported an air conditioner that has been broken for months. This unit is crucial for cooling the operating room, ensuring comfort for surgeons and proper functioning of equipment. Patients not requiring general anesthesia also endure discomfort due to the excessive heat.
Janine Hill, the hospital’s CEO, mentioned that air conditioning repairs are planned, and the hospital aims to obtain an ultrasound machine. However, she acknowledged, 'Other necessities are still lacking,' including a hematology analyzer and other basic hospital equipment.
