Featured Research

from universities, journals, and other organizations

Researchers Design Re-engineered Hospital Discharge Program To Reduce Rehospitalization

Date:
February 2, 2009
Source:
Boston University
Summary:
Researchers in Boston have designed a process to minimize discharge failures. The Re-Engineered Discharge program reduces hospital utilization within 30 days of discharge by over 30 percent, by redesigning the discharge workflow process.

Researchers from Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) have designed a process to minimize discharge failures. The Re-Engineered Discharge (RED) program reduces hospital utilization within 30 days of discharge by over 30 percent, by redesigning the discharge workflow process.

These findings appear in the February issue of the Annals of Internal Medicine.

One in five hospitalizations is complicated by a post-discharge adverse event. The lack of standards for hospital discharge often leads to increased patient morbidity, further hospital utilization and greater costs. Patients often are unprepared at discharge, do not understand their medications and/or cannot recall their diagnosis.

A randomized control trial was performed at BMC to evaluate the clinical impact of implementing RED among patients admitted to a general medical service. A randomized controlled trial was conducted that included 738 patients, 368 in the usual care group and 370 in the intervention group.

Study nurses called discharge advocates (DAs) performed all aspects of the in-hospital intervention. DAs were trained to deliver the RED intervention; their responsibilities include coordinating a discharge plan with the hospital team as well as to educate and prepare the patient for discharge. With information collected from the hospital team and the patient, the DA creates the After Hospital Care Plan (AHCP). The plan comprises a medical provider contact information sheet, dates for appointments and tests, an appointment calendar, a color-coded medication schedule, a list of tests with pending results at discharge, an illustrated description of the discharge diagnosis and information about what to do if a problem arises. On the day of discharge, a copy of the AHCP is given to the patient and a discharge summary was faxed to the patient's primary care physician.

Patients were called by a clinical pharmacist two to four days after being discharged, to reinforce the discharge plan. Patients were asked to review and address any medication-related problems. The pharmacist then relayed these issues to the primary care physician and/or the DA.

In the intervention group, 94 percent were discharged with a primary care appointment, 83 percent left with an AHCP, and 91 percent had their discharge information sent to their primary care physician within 24 hours after discharge. In the usual care group, 35 percent were discharged with a primary care appointment, data regarding medication reconciliation and discharge summary transfer to the primary care physician was unavailable.

The difference between study groups in total cost (combining actual hospital utilization cost and estimated outpatient cost) for 738 subjects was $149,995—or an average of $412 per person who received the intervention. This represents a 33.9% lower observed cost for the intervention group.

"The RED intervention program decreased hospital utilization within 30 days of discharge by 30 percent among patients on a general medical service," explains principal investigator Brian Jack, MD, vice chair of family medicine at Boston Medical Center, and associate professor of family medicine at Boston University School of Medicine. "One emergency department visit or re-hospitalization was prevented for every seven patients receiving the intervention. Intervention patients reported seeing their primary care physician for follow-up appointments within 30 days and reported higher levels of preparedness for discharge," said Jack.

Research for this study was funded by the Agency for Healthcare Research and Quality, the National Heart, Lung and Blood Institute and the National Institutes of Health.


Story Source:

The above story is based on materials provided by Boston University. Note: Materials may be edited for content and length.


Cite This Page:

Boston University. "Researchers Design Re-engineered Hospital Discharge Program To Reduce Rehospitalization." ScienceDaily. ScienceDaily, 2 February 2009. <www.sciencedaily.com/releases/2009/02/090202174836.htm>.
Boston University. (2009, February 2). Researchers Design Re-engineered Hospital Discharge Program To Reduce Rehospitalization. ScienceDaily. Retrieved August 21, 2014 from www.sciencedaily.com/releases/2009/02/090202174836.htm
Boston University. "Researchers Design Re-engineered Hospital Discharge Program To Reduce Rehospitalization." ScienceDaily. www.sciencedaily.com/releases/2009/02/090202174836.htm (accessed August 21, 2014).

Share This




More Health & Medicine News

Thursday, August 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com
Lost Brain Cells To Blame For Sleep Problems Among Seniors

Lost Brain Cells To Blame For Sleep Problems Among Seniors

Newsy (Aug. 21, 2014) According to a new study, elderly people might have trouble sleeping because of the loss of a certain group of neurons in the brain. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins