Although these actions are sensible, data have suggested that the issue is more complicated. Only a minority of patients treated for common conditions such as heart failure, chronic obstructive pulmonary disease, and pneumonia are readmitted for precisely the same problem.2 It seems that patients who leave the hospital have their physiological balance disrupted and are subsequently susceptible to a broad range of acute medical problems.
The depersonalizing and stressful hospital atmosphere that exposes patients to incessant loud noises, a lack of privacy, awakenings in the middle of the night, and examinations by strangers who fail to identify themselves may be an important contributing cause of transient vulnerability that has been characterized as “posthospital syndrome.”3 It may be meaningful that this term is similar to posttraumatic stress disorder, implying that the solution starts with ways to reduce the trauma of the hospitalization. What would it take for hospitals to become truly healing environments? Are some principles so clear that action should be taken now rather than after years of study? This Viewpoint offers suggestions for consideration.