TY - JOUR
T1 - How Hospitals Reengineer Their Discharge Processes to Reduce Readmissions
AU - Mitchell, Suzanne E.
AU - Martin, Jessica
AU - Holmes, Sally
AU - Van Deusen Lukas, Carol
AU - Cancino, Ramon
AU - Paasche-Orlow, Michael
AU - Brach, Cindy
AU - Jack, Brian
N1 - Funding Information:
This research was under contract to the Agency for Healthcare Research and Quality Contract No. HHSA290200600012i, TO #8, Rockville, MD. The authors of this article are responsible for its content.No statement may be construed as the official position of the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services.
Publisher Copyright:
© 2015 National Association for Healthcare Quality.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - The Re-Engineered Discharge (RED) program is a hospital-based initiative shown to decrease hospital reutilization. We implemented the RED in 10 hospitals to study the implementation process. Design: We recruited 10 hospitals from different regions of the United States to implement the RED and provided training for participating hospital leaders and implementation staff using the RED Toolkit as the basis of the curriculum followed by monthly telephone-based technical assistance for up to 1 year. Methods: Two team members interviewed key informants from each hospital before RED implementation and then 1 year later. Interview data were analyzed according to common and comparative themes identified across institutions. Readmission outcomes were collected on participating hospitals and compared pre-versus post-RED implementation. Results: Key findings included (1) wide variability in the fidelity of the RED intervention; (2) engaged leadership and multidisciplinary implementation teams were keys to success; (3) common challenges included obtaining timely follow-up appointments, transmitting discharge summaries to outpatient clinicians, and leveraging information technology. Eight out of 10 hospitals reported improvement in 30-day readmission rates after RED implementation. Conclusions: A supportive hospital culture is essential for successful RED implementation. A flexible implementation strategy can be used to implement RED and reduce readmissions.
AB - The Re-Engineered Discharge (RED) program is a hospital-based initiative shown to decrease hospital reutilization. We implemented the RED in 10 hospitals to study the implementation process. Design: We recruited 10 hospitals from different regions of the United States to implement the RED and provided training for participating hospital leaders and implementation staff using the RED Toolkit as the basis of the curriculum followed by monthly telephone-based technical assistance for up to 1 year. Methods: Two team members interviewed key informants from each hospital before RED implementation and then 1 year later. Interview data were analyzed according to common and comparative themes identified across institutions. Readmission outcomes were collected on participating hospitals and compared pre-versus post-RED implementation. Results: Key findings included (1) wide variability in the fidelity of the RED intervention; (2) engaged leadership and multidisciplinary implementation teams were keys to success; (3) common challenges included obtaining timely follow-up appointments, transmitting discharge summaries to outpatient clinicians, and leveraging information technology. Eight out of 10 hospitals reported improvement in 30-day readmission rates after RED implementation. Conclusions: A supportive hospital culture is essential for successful RED implementation. A flexible implementation strategy can be used to implement RED and reduce readmissions.
KW - Readmission
KW - care transitions
KW - rehospitalization
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U2 - 10.1097/JHQ.0000000000000005
DO - 10.1097/JHQ.0000000000000005
M3 - Article
C2 - 26042743
AN - SCOPUS:84978224572
VL - 38
SP - 116
EP - 126
JO - Journal of quality assurance : a publication of the National Association of Quality Assurance Professionals
JF - Journal of quality assurance : a publication of the National Association of Quality Assurance Professionals
SN - 1062-2551
IS - 2
ER -