AHRQ Innovations Exchange | Standardized Discharge Planning Focusing on Patient Education and Care Coordination Increases Understanding of Postdischarge Needs and Likelihood of Followup Care

Standardized Discharge Planning Focusing on Patient Education and Care Coordination Increases Understanding of Postdischarge Needs and Likelihood of Followup Care

Snapshot
Summary
The Re-Engineered Discharge project (Project RED) at Boston Medical Center standardizes the hospital discharge process through the use of 11 separate but mutually reinforcing steps that health care professionals follow from patient admission to postdischarge. The steps incorporate the provision of patient education, care coordination with primary care physicians, and postdischarge followup with a pharmacist. The program reduced the rate of hospital readmissions and emergency department visits in the first month after discharge, improved patients’ understanding of postdischarge needs, and increased the likelihood of timely followup care.

See the Description section for updated information about the addition of a virtual patient advocate position (updated April 2010).

Evidence Rating
Strong: The evidence consists of a randomized controlled trial that assesses various measures related to patients’ preparedness for self-care, understanding of postdischarge roles and responsibilities, and the likelihood of receiving followup PCP care.

Developing Organizations
Boston Medical Center



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AHRQ Innovations Exchange | Standardized Discharge Planning Focusing on Patient Education and Care Coordination Increases Understanding of Postdischarge Needs and Likelihood of Followup Care