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

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