Developing the Tools to Administer a Comprehensive Hospital Discharge Program: The Re-Engineered Discharge (RED) Program

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Developing the Tools to Administer a Comprehensive Hospital Discharge Program: The Re-Engineered Discharge (RED) Program

Introduction: The hospital discharge is nonstandardized and marked with poor quality. One in five hospital discharges is complicated by an adverse event (AE) within 30 days, many of which lead to emergency department visits and rehospitalizations. Methods: Using an iterative group process, we developed the principles and components of the ReEngineered Discharge (RED), a set of 11 distinct components designed to prepare patients for discharge. Three tools were created: a training manual used to train discharge nurses to provide the RED; an individualized, patient-friendly “After Hospital Care Plan” (AHCP), a booklet used to prepare patients for discharge; and a workstation to integrate all pertinent discharge information used to electronically create the AHCP. Outcomes: The RED was adopted by the National Quality Forum (NQF) as one of their “Safe Practices.” Among the intervention subjects, 89 percent were provided with an AHCP at discharge; it required approximately 1 hour for the discharge advocate to provide the RED intervention. Implications: Use of the AHCP tool can effectively prepare patients for discharge, as recommended by NQF 2006 Safe Practice number 11. These results have important implications for quality of care at discharge and for lowering costs.

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