Anatomy of a hospital 'bounce-back'

Published at Fierce Healthcare on March 5, 2010: As a physician who works as a hospitalist and a primary-care doctor, I understand the complexity of discharging a patient from the hospital, and all the moving pieces that must come together to successfully transition a patient back to the outpatient setting.

If even one link in the chain fails, a patient often ends up back in the emergency department and/or readmitted to the hospital as, in hospital-speak, a 'bounce-back.'

These readmissions are like a canary in a coal mine, alerting us that our hospital-outpatient continuum is seriously disconnected and dysfunctional. And Medicare is now tracking readmissions for several diagnoses while threatening to withhold payment to hospitals for readmissions.