UBC Reports | Vol. 49 | No. 8 | Aug. 7, 2003

Shortened Hospital Stays not Always a Blessing

Researchers look for a better way

By Hilary Thomson

Returning home after a hospital stay should be a relief.

For many patients, however, it can be a frustrating struggle to prepare special diets, juggle pain medications or even shower with bandages on.

The transition from hospital to home is one that Joan Anderson, a professor in the School of Nursing, is determined to improve.

“Many people just don’t anticipate what it will be like when they get home,” says Anderson. “They are told but often can’t comprehend the full picture.”

Anderson, and researchers from UBC’s School of Nursing and the School of Rehabilitation Sciences, Trinity Western University and four Lower Mainland hospitals, have launched a three-year study to evaluate the experience of 90 patients from three different ethnocultural groups: first generation Indo- and Chinese-Canadians and Anglo-Canadians born in Canada.

The team, which includes hospital policy-makers and clinicians, has examined the impact of health-care reform -- such as shortened hospital stays -- on hospital patients and staff. They are also looking at the discharge planning process and difficulties patients may face on their return home.

“People in obvious need are easily assessed, but many people fall through the cracks,” says Anderson, who is one of this year’s Distinguished Scholars in Residence at the Peter Wall Institute for Advanced Study at UBC.

Key issues include patients’ ability to communicate with health-care professionals. Many non-English speakers don’t realize hospitals provide interpreter services.

“I was able to ask only the ones [questions] I knew how to ask…. but there were some words that I didn’t know how to say, so I couldn’t ask those questions,” said one Cantonese-speaking patient.

Information overload is another problem.

“The information that the dietician gave me… was overwhelming. I broke into tears… The stuff she told me was right, there was nothing wrong with that. It’s just that you need to know where to start when you go home,” said one patient.

Patients have suggested a phone line service would help them to consult easily with health professionals once they get home. They need detailed instructions and advice that the generic discharge pamphlet cannot provide.

People can also underestimate the length of time off work and the resulting financial strain. Especially difficult for self-employed workers, income loss is made worse by costs of medications or equipment.

Anderson emphasizes that information from the study is helping to improve practice already.

“The staff in hospitals are committed people and they are anxious to know what we are finding so that they can make necessary changes. We’re finding that some of the things that are most distressing to people when they get home can be addressed in a cost-effective way and might indeed prevent them from ending up in the hospital again,” she says.

When the study is completed, researchers will work with provincial policy makers to implement the research findings.