jueves, 26 de abril de 2012

Preventing Avoidable Readmissions: Improving the Hospital Discharge Process


Men More Likely To Be Readmitted to Hospital after Discharge

Men are more likely than women to be readmitted to the hospital within a month after being discharged, according to a new AHRQ-funded study. The risk for returning to the hospital within 30 days is higher among men who are retired, unmarried, screen positive for depression or don’t visit a primary care physician for follow-up after their hospitalization, according to the study from researchers at Boston University School of Medicine. The article was published online in BMJ Open. Returning to the hospital within 30 days following discharge occurs frequently and is often linked to complications and longer recovery times. Nearly one in five Medicare patients returned to the hospital within 30 days after discharge from 2003 to 2004 at an estimated yearly cost of $17.4 billion. Previous research by the Boston University School of Medicine team found that hospital staff could lower the incidence of hospital readmission by 30 percent through specific, coordinated efforts, including providing clear instructions to patients about what they need to do once they leave the hospital and following up with patients after discharge. In the new study, the only risk factor that predicted whether men and women were likely to be readmitted to the hospital within 30 days was whether they had been hospitalized in the previous 6 months. Select to access AHRQ information to help improve the hospital discharge process.


Preventing Avoidable Readmissions: Improving the Hospital Discharge Process


Preventing Avoidable Readmissions

Partnerships for Patients 
AHRQ's research in the area of improving care transitions and the hospital discharge process help attain the goals of the Department of Health and Human Services' Partnership for Patients initiative, a nationwide public-private partnership that aims to make care safer for patients and reduce unnecessary return visits to the hospital while making care less costly. Select for more information on the initiative.

Improving the Hospital Discharge Process


The Agency for Healthcare Research and Quality offers information and tools for clinicians and patients to make the hospital discharge process safer and to prevent avoidable readmissions. This page features links to AHRQ's resources for preventing avoidable readmissions or trips to the emergency room.
Information and Tools for Clinicians | Information and Tools for Consumers

Patients being discharged from the hospital who have a clear understanding of their after-hospital care instructions, including how to take their medicines and when to make follow-up appointments, are 30 percent less likely to be readmitted or visit the emergency department than patients who lack this information, according to an AHRQ-funded study.
AHRQ offers the information and tools below to help reduce the number of preventable hospital readmissions.

Information and Tools for Clinicians

Project RED (Re-Engineered Discharge)—An evidence-based project from AHRQ grantee Brian Jack, M.D., Boston University Medical Center, that offers tools to improve the hospital discharge process by preparing patients for discharge from the moment they arrive in the hospital, designating a Discharge Advocate to coordinate discharge with the care team and patient, and improving information flow with community primary care providers.
Useful Links:
  • Project RED Summary Webinar Audio, December 2011 (Transcript)
    Provides a wealth of examples of how hospitals successfully used Project RED to reduce readmission rates. Streaming Audio (MP3, 126MB; Plugin Software Help). Transcript.
  • Project RED (Re-Engineered Discharge) Training Program
    Helps hospitals learn how to re-engineer their discharge process via study modules and supporting materials.
    http://www.ahrq.gov/qual/projectred/
  • Technical Assistance for Implementing Project RED
    Provides an overview of an AHRQ project that provides free technical assistance to help hospitals implement Project RED.
    http://www.jcrinc.com/AHRQ-Project-Red Exit Disclaimer
  • Overview of Project RED
    Gives a description of Project RED and links to presentations, tools, and case studies.
    http://www.ahrq.gov/qual/pips/jack.htm
  • Project RED Toolkit Web Site
    Provides an overview of and links to Project RED's products forPreventing Avoidable Readmissions: Improving the Hospital Discharge Process.
    http://www.bu.edu/fammed/projectred/ Exit Disclaimer
  • Frequently Asked Questions on Project RED Implementation
    Provides answers to questions on implementing Project RED.
    http://www.ahrq.gov/news/kt/red/redfaq.htm
  • Taking Care of Myself: A Guide for When I Leave the Hospital
    Guide for hospital staff to use during hospital discharge to help patients track their medication schedules, medical appointments, and important phone numbers.
    http://www.ahrq.gov/qual/goinghomeguide.htm


Improving Hospital Discharge Through Medication Reconciliation and Education—A "discharge bundle" consisting of medication reconciliation forms, a checklist for patient-centered hospital discharge education, and a checklist for post-discharge continuity checks. AHRQ grantee Mark Williams, M.D., Emory University, developed this discharge bundle, which is also known as Project BOOST (Better Outcomes for Older Adults through Safer Transitions). Hospitals nationwide have used Project BOOST's evidence-based method of better organizing and standardizing the sometimes chaotic patient discharge process.
Useful Links:
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Information and Tools for Consumers

Project RED (Re-Engineered Discharge)—Provides an overview of and links to products from AHRQ grantee Brian Jack, M.D., Boston University Medical Center, that offers tools to improve the hospital discharge process by preparing patients for discharge from the moment they arrive in the hospital, designating a Discharge Advocate to coordinate discharge with the care team and patient, and improving information flow with community primary care providers.
Useful Links:
  • Taking Care of Myself: A Guide for When I Leave the Hospital
    Easy-to-read guide for patients to use at discharge that helps them track medication schedules, upcoming medical appointments, and important phone numbers.
    http://www.ahrq.gov/qual/goinghomeguide.htm
  • Better Information Helps Patients When They Leave the Hospital
    Advice column from AHRQ Director Carolyn Clancy, M.D., that explains the features and benefits of Project RED.
    http://www.ahrq.gov/consumer/cc/cc121608.htm
  • How to Avoid the Round-Trip Visit to the Hospital
    Advice column from AHRQ Director Carolyn Clancy, M.D., that describes Taking Care of Myself: A Guide for When I Leave the Hospital and how it can help prevent avoidable readmissions to the hospital.
    http://www.ahrq.gov/consumer/cc/cc060110.htm
  • Podcast: Tips for Going Home from the Hospital
    Podcast stresses the need to clarify all aspects of your medical care, including medications, before leaving the hospital.
    http://healthcare411.ahrq.gov/videocast.aspx?id=690
  • Podcast: Making Hospital Discharges Safer for Seniors
    Podcast on how information technology is making the transition from hospital to home safer for seniors.
    http://healthcare411.ahrq.gov/featureAudio.aspx?id=970
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Current as of October 2011

Internet Citation:
Preventing Avoidable Readmissions: Improving the Hospital Discharge Process. October 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/impptdis.htm



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