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:12/5/2016)... ... ... For many years, Andrew G. Zubinas has accumulated over 130 hardcover ... Lithuanian language and its poetry inspired him in writing “ Forest Lungs ... aspects of a living, breathing forest where nothing ever stays the same. His subjects ...
(Date:12/5/2016)... ... December 05, 2016 , ... ... announced today that nominations will be accepted from December 5, 2016 through ... , Awards include the Information Security Executive® of the Year, which recognizes ...
(Date:12/5/2016)... ... December 05, 2016 , ... Worldwise ... global lifestyle design firm kathy ireland® Worldwide for five additional years, announced by ... into an exclusive licensing agreement three years ago to design and develop the ...
(Date:12/5/2016)... ... December 05, 2016 , ... Progressive ... of L-Citrulline and glutathione to enhance production of nitric oxide (NO). , NitroGenesis ... shown to produce NO twice as effectively and sustains NO blood levels twice ...
(Date:12/5/2016)... ... December 05, 2016 , ... ICA, ... alerting technology to Central Illinois Health Information Exchange (CIHIE) using its Smart ... as the sole sub-recipient participating with the Illinois Health Information Exchange Authority ...
Breaking Medicine News(10 mins):
(Date:12/5/2016)... According to a new market research report "Cartilage Repair/ ... Tissue Scaffolds, Cell-free composites), Application (Hyaline Cartilage, Fibrocartilage), by Region - ... reach USD 779.8 Million by 2021 from USD 414.6 Million in ... of 2016 to 2021. Continue Reading ... ...
(Date:12/5/2016)... PUNE, India , December 5, 2016 According ... by Product Type and by Application - Global Opportunity Analysis and Industry Forecast, ... 2015, and is expected to reach $5,255 million by 2022, growing at a ... in 2015 with more than four-fifths share. Continue ... ...
(Date:12/5/2016)... and PUNE, India , December ... report by Allied Market Research, titled, "Global Cancer Biomarkers Market ... revenue of cancer biomarkers market is projected to reach $15,737 ... CAGR of 13.3% from 2016 to 2022. Omic technologies segment ... 2015 and is expected to maintain its dominance during the ...
Breaking Medicine Technology: