AHRQ’s Hospital-Based Re-Engineered Discharge Program Adaptable to Skilled Nursing Facilities

An AHRQ-funded toolkit designed to improve the hospital discharge process can be adapted for use in skilled nursing facilities (SNFs), according to a study published in the Journal of Nursing Care Quality. Researchers tracked the implementation of AHRQ’s Re-Engineered Discharge (RED) toolkit over 18 months at four short-stay SNFs in the Midwest. They evaluated whether the RED toolkit could help involve family members and caregivers with patient-focused discharge plans; reconnect patients quickly to primary care providers; and educate patients at discharge about their health condition, medications and other chronic health needs. While staff capacity and corporate-level policies may limit adoption of some components, transitional care processes such as RED can be adapted for SNFs to improve discharges, researchers concluded. Access the abstract.

2018 Dec 17:1054773818819261. doi: 10.1177/1054773818819261. [Epub ahead of print]

Adapting Project RED to Skilled Nursing Facilities.

Popejoy LL1, Vogelsmeier AA1, Wakefield BJ1, Galambos CM2, Lewis AM1, Huneke D3, Mehr DR1.

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Abstract

This article describes our recommendation for adapting hospital-based RED (Reengineered Discharge) processes to skilled nursing facilities (SNFs). Using focus groups, the SNFs' discharge processes were assessed twice additionally, research staff then recorded field notes documenting discussions about facility discharge processes as they related to RED processes. Data were systematically analyzed using thematic analysis to identify recommendations for adapting RED to the SNF setting including (a) rapidly identifying, involving, and preparing family/caregivers to implement a patient focused SNF discharge plan; (b) reconnecting patients quickly to primary care providers; and (c) educating patients at discharge about their target health condition, medications, and impact of changes on other chronic health needs. Limited SNF staff capacity and corporate-level policies limited adoption of some key RED components. Transitional care processes such as RED, developed to avoid discharge problems, can be adapted for SNFs to improve their discharges.