Navigation Links
Researchers design re-engineered hospital discharge program to reduce rehospitalization
Date:2/4/2009

(Boston)-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 $149,995or 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.


'/>"/>

Contact: Allison Rubin
allison.rubin@bmc.org
617-638-8491
Boston University
Source:Eurekalert

Related medicine news :

1. Stanford researchers find culprit in aging muscles that heal poorly
2. UCLA researchers identify markers that may predict diabetes in still-healthy people
3. Mayo Clinic researchers discover new diagnostic test for detecting infection in prosthetic joints
4. Bipolar disorder relapses halved by Melbourne researchers
5. Cell that triggers symptoms in allergy attacks can also limit damage, Stanford researchers find
6. High and mighty: first common height gene identified by researchers behind obesity gene finding
7. Researchers estimate about 9 percent of US children age 8 to 15 meet criteria for having ADHD
8. Majority of 2.4 Million U.S. Children With ADHD Not Diagnosed or Consistently Treated, According to New Gold Standard Study by Cincinnati Childrens Researchers
9. Researchers develop long-lasting growth hormone
10. Jefferson immunology researchers halt lethal rabies infection in brain
11. Purdue researchers develop technology to detect cancer by scanning surface veins
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:9/22/2017)... Viejo, CA (PRWEB) , ... September 22, 2017 , ... ... Angioma Alliance Walk and 5K honoring Olympian, Florence Joyner, still considered the fastest woman ... malformation (CCM). Flo Jo’s daughter, Mary Joyner, will sing the National Anthem. ...
(Date:9/22/2017)... ... 22, 2017 , ... After a long health ordeal that ... lease on life with assistance from CreditAssociates. CreditAssociates provides debt relief and debt ... debt. The senior is one of the satisfied clients who expressed their appreciation ...
(Date:9/22/2017)... ... September 22, 2017 , ... Pullano Law Offices, a ... L. Pullano has been selected to serve as President of the North Suburban ... the Installation and Award Dinner hosted by the NSBA at the North Shore Country ...
(Date:9/22/2017)... ... September 22, 2017 , ... ... explores the world of Alzheimer’s. Alzheimer’s is a disease estimated to affect the ... to information published by the Alzheimer’s Association, a leading voice in the fight ...
(Date:9/22/2017)... CA (PRWEB) , ... September 22, 2017 , ... ... groceries, wearable, and more products at customers’ doorstep. According to Smart Mart, customers ... Mart has stated to offer wearable, and customers can find clothing at discounted ...
Breaking Medicine News(10 mins):
(Date:9/5/2017)... 2017 Sapheneia and Scannerside received FDA 510(k) ... is a third-party Vendor neutral CT product that makes ... compliance with current MITA standards. ... solution is specifically designed to provide CT operators, prior ... doses over a predefined threshold. Scannerside Dose Check is ...
(Date:9/1/2017)... Mass. , Sept. 1, 2017 ... HealthCare Solutions, Inc , highlights opportunities for growth in ... Journal report that Marlin Equity is seeking a buyer ... an annual award-winning 22-year-old healthcare solutions Value Added Reseller ... "As the healthcare ...
(Date:8/29/2017)... , Aug. 29, 2017 In a ... security, and regulatory compliance for veterinary practices of all ... a new partnership that makes TITAN,s expertise in physical ... available to Cubex,s clients nationally. ... buying and handling controlled substances is at risk today," ...
Breaking Medicine Technology: