Image: Research shows implementing a patient discharge plan can reduce readmission rates (Photo courtesy of AdobeStock).
A standardized hospital-based program provides patients and caregivers the information they need to continue care at home.
Developed at Boston Medical Center (BMC, MA, USA) and Torrance Memorial Health System (CA, USA), the ReEngineered Discharge (RED) program, first implemented in 2007, is an after hospital care plan (AHCP) set of strategies aimed at improving the discharge process in a way that promotes patient safety and reduces readmission rates and emergency department visits. The AHCP is formatted with large font, color, icons, and simple clear language. It includes information about medications, future appointments, future and pending tests, and a calendar of activities scheduled over the next 30 days.
The AHCP is reviewed with the patient before discharge, and, as part of the RED program, discharge summaries are sent to the primary care provider within 48 hours of discharge. In addition, a telephone call is made to the patient within 48 hours of discharge for reinforcement. In a study to examine the impact of RED on the patient’s experience, the researchers compared post-hospitalization responses to the Press Ganey survey item called “Instructions were given about how to care for yourself at home.”
The researchers compared survey results for patients receiving the RED program, a standard discharge on the same hospital unit, or a standard discharge on other hospital units. The resulted showed that patients who received the RED intervention were significantly more likely to choose the top-box "very good" response to the Press Ganey survey item (61%) than those receiving a standard discharge on other hospital units (41%), compared to those who did not receive the RED intervention (35%). The study was published online on June 16, 2017, in the Journal of Patient Experience.
“Improving patient experience by helping them better understand how to care for themselves in the transition from hospital to home means that we're improving their overall quality of care while decreasing hospital readmission and decreasing the cost of care, which is our primary goal,” said senior author Brian Jack, MD, chief of family medicine at BMC, who created the Project RED program.
Poor preparation for discharged patients can result in confusion about medicines, follow-up and tests appointments, pending test results, and diagnoses. Coupled with the frailty many experience during the hospital to home transition, it is no surprise that many adverse events occur after discharge or that 20% of patients return to the hospital within 30 days of hospital discharge.
Boston Medical Center
Torrance Memorial Health System