How Hospitals Reengineer Their Discharge Processes to Reduce Readmissions
- Resource Type
- Authors
- Ramon S. Cancino; Jessica Martin; Suzanne E. Mitchell; Brian W. Jack; Sally Ann Holmes; Cindy Brach; Carol VanDeusen Lukas; Michael K. Paasche-Orlow
- Source
- Journal for Healthcare Quality. 38:116-126
- Subject
- Quality management
media_common.quotation_subject
MEDLINE
Fidelity
Patient Readmission
Article
Interview data
Interviews as Topic
03 medical and health sciences
0302 clinical medicine
Multidisciplinary approach
medicine
Humans
030212 general & internal medicine
Curriculum
Qualitative Research
media_common
business.industry
030503 health policy & services
Health Policy
Public Health, Environmental and Occupational Health
Information technology
medicine.disease
Quality Improvement
Patient Discharge
United States
Medical emergency
0305 other medical science
business
Qualitative research
- Language
- ISSN
- 1062-2551
Background 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.