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Quality Management in Health Care:
doi: 10.1097/QMH.0000000000000032
Original Articles

Implementation of the Re-Engineered Discharge (RED) Toolkit to Decrease All-Cause Readmission Rates at a Rural Community Hospital

Adams, Carol J. DNP, BSM, RN; Stephens, Kimberly DNP, RN; Whiteman, Kimberly DNP, RN; Kersteen, Hal MBA; Katruska, Jeanne BSN, RN

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Abstract

Overview: National hospital readmission rates average 19%. One in 5 Medicare patients are readmitted within 30 days of discharge each year, resulting in $17.5 billion in additional costs.

Objective/Purpose: The aim of this quality improvement project was to use the methodology outlined by Joint Commission Resources-Hospital Engagement Network and Project Re-Engineered Discharge (Project RED) to redesign the discharge process, reduce hospital 30-day all-cause readmission rates, and improve patient/family involvement in the discharge process.

Method: The methodology of the Joint Commission Resources-Hospital Engagement Network and the Agency for Healthcare Research and Quality Project RED toolkit, the After Hospital Care Plan, and a patient discharge questionnaire were used to incorporate best discharge practices into patient care and evaluate the outcomes of the project. Monthly readmission rates and patient/family involvement in the discharge process were examined for 336 patients discharged from a dedicated 30-bed medical-surgical unit in a rural community hospital over a 4-month period.

Results: During the 4-month project, readmissions were reduced by 32% (rate 7.12); the overall monthly reduction from baseline was 27%, with a 44% reduction from baseline during the previous 6 months. The patient and family perception of their discharge process was positive.

© 2014Wolters Kluwer Health | Lippincott Williams & Wilkins

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