<p>Valley Regional Hospital READMISSION QUERY When a patient is readmitted, conduct the following investigation. Today’s date: ______</p><p>Patient name: ______Date of 1st admission: ______Date of this admission: ______□ through ED □ Direct</p><p>I. Interview the patient and or family How do you think you became sick enough to come back to the hospital? ______</p><p>Have you seen your doctor in the office since you left the hospital? □ Yes Date: ______□ No I had an appointment scheduled for: ______</p><p>Have you seen any other specialist since you were here? □ Yes Date: ______Who? ______□ No</p><p>Did you have difficulty reaching your doctor or getting an office visit? □ Yes □ No ______Have you had trouble purchasing medications or even taking them? □ Yes □ No ______</p><p>Have you had trouble with getting your meals at home? □ Yes □ No ______</p><p>Did you feel ready for discharge when you left the last time? □ Yes □ No ______</p><p>Did you receive the services you thought were set up on discharge? □ Yes □ No What were those services? ______</p><p>Did you call your physician before you came to the ED? □ Yes □ No Did you physician tell you to come in? □ Yes □ No </p><p>If the patient had VNA ordered Did you call the VNA before you came? □ Yes □ No ______Did the VNA tell you to come to the hospital? □ Yes □ No ______Do you know if the VNA called your physician? □ Yes □ No ______</p><p>II. If the patient has home care services, Call them to discuss the patient’s admission.</p><p>III. If the patient came from an extended facility, Call them to discuss the patient’s admission.</p><p>IV. Ask the Care Team Members: What do you think caused the patient to be readmitted? ______</p><p>4/2012 ______</p><p>4/2012</p>