A recent study, published in the Journal of Aging Research, shows that almost 25% of recommendations made by the hospital discharge team to the nursing homes were not followed. The goal for the research team was to document how often recommendations were not followed. The three most common recommendations not followed in the study were subspecialty referrals, laboratory tests, and medication changes/monitoring.
The study notes that the hospital in the study used electronic records while all the nursing homes still were using written records. To reduce miscommunication, especially for patients transferring to multiple sites, it makes more sense for everyone to be able to consult the same typewritten record. This will result in a reduction of errors and lack of follow-up on recommendations.
For the majority of those recommendations that were not acted upon, a reason could not be determined. For this study, the next site of care was the nursing home, where the physician and/or the non-physician practitioner reviewed the recommendations to determine future actions. Researchers are looking into why nursing homes don’t always follow guidance by the referring hospitals. Further investigation is needed to determine if an association exists between the missed recommendations and hospital readmission from the nursing home setting.