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:2/10/2016)... ... February 10, 2016 , ... Compliancy Group LLC is pleased ... professionals throughout the country. The Guard was specifically designed to handle each element ... training, regulatory updates, and compliance coaching. , In addition to meeting the compliance ...
(Date:2/10/2016)... SAN FRANCISCO, Calif. (PRWEB) , ... February 10, 2016 , ... ... category: Best Water Brand. There were three leading bottled water brand owners that topped ... edge services that enhance connectivity and optimize conversion. The premier brand was Tibet 5100, ...
(Date:2/10/2016)... ... 2016 , ... Ongoing news of the ravages of traumatic brain injury (TBI) ... survey that takes a closer look at cases of TBI being managed by their ... TBI among the aging population, and identifies the challenges associated with their care. , ...
(Date:2/10/2016)... (PRWEB) , ... February 10, 2016 , ... Gout is ... and brings pain that is often severe, with intense swelling and redness. It is ... eight million people, but older adults are the most susceptible, according to the February ...
(Date:2/10/2016)... ... February 10, 2016 , ... AHRA: The Association ... inspirational speaker Jan Fox will serve as keynote speaker at the organization’s 2016 ... with tools to more effectively communicate with their own organizational staff and leadership. ...
Breaking Medicine News(10 mins):
(Date:2/10/2016)... 2016 Urologix, the market leader for in-office ... Prostatic Hyperplasia (BPH), announces new private ownership and is ... medical device industry veteran of more than 20 years, ... Plymouth, Minn. The ... and Prostiva® RF Therapy, will continue to be broadly ...
(Date:2/10/2016)... 2016 Immune Pharmaceuticals Inc. (NASDAQ: IMNP ... it has filed a patent application directed to the ... --> --> The new ... Ceplene (histamine dihydrochloride) in combination with immune checkpoint inhibitors. ... efficacy of Ceplene and IL-2 therapy in patients with ...
(Date:2/10/2016)... Feb. 10, 2016  Rich Pharmaceuticals, Inc. (OTC Markets: ... 1-for-100 reverse split of its issued and outstanding shares ... on Thursday, February 11, 2016. The Company,s common stock ... number 76303T308 and temporary ticker symbol "RCHAD". After 20 ... the ticker symbol (RCHA).  --> ...
Breaking Medicine Technology: