Rush University Medical Center studies program to help older adults transition from hospit...( In light of health care reform measu...),Health

In light of health care reform measures, Rush University Medical Center has launched a study of its program to help older adults transition from hospital to home.

The goal of the study is to determine whether the program, first implemented two years ago, succeeds in reducing readmissions within 30 days for seniors. If it does, it could serve as a model for hospitals across the country that are seeking ways to lower their rates of readmission.

On average, one in five Medicare beneficiaries who are discharged from a hospital re-enter the hospital within a month. Reducing the rate of hospital readmissions to improve quality and achieve savings are key components of President Obama's health care reform agenda. Hospital readmissions cost Medicare an estimated $12 billion dollars annually.

"Patients who have been enrolled in our enhanced discharge planning program over the last two years are extremely pleased with the service," said Robyn Golden, LCSW, director of the older adult programs at Rush. "But beyond patient satisfaction, we now need to formally evaluate the program in a randomized, controlled study to determine whether our modelusing social workers rather than nursesnot only reduces readmissions, but also reduces emergency room visits, avoids nursing home placements, and improves quality of life."

The program targets seniors 65 years of age and older who are discharged to their homes and have multiple prescribed medications, plus other risk factors.

Within 48 hours of discharge from the hospital, the patient receives a call from a Rush social worker, whose responsibility is to ensure full implementation of the discharge plan, assist with coordinating community resources and followup appointments, and intervene around any issues that might arise once the patient is back in the community. Those issues may range from transportation to meals and in-home care.

Over the two years of the Rush program, the soc
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