Reengineering Skilled Nursing Facility Discharge: Analysis of Reengineered Discharge Implementation

Lori L Popejoy 1, Bonnie J Wakefield, Amy A Vogelsmeier, Colleen M Galambos, Alexandria M Lewis, Diane Huneke, Greg Petroski, David R Mehr

Affiliations

PMID: 31145185
PMCID: PMC7008493 (available on 2021-04-01)
DOI: 10.1097/NCQ.0000000000000413

Free PMC article

Abstract

Background: There is a need to adopt evidence-based approaches to discharge planning in the skilled nursing facility (SNF) short stay population.

Purpose: This article describes implementation of the Reengineered Discharge (RED) process in SNFs and makes recommendations for its future implementation.

Methods: The methods included a pre- and postanalysis of an 18-month RED implementation with a contemporaneous comparison of 4 Midwestern SNFs randomly assigned to 2 different RED implementation strategies. The Standard facilities received less implementation than Enhanced facilities.

Results: Standard SNFs made more improvements and were more satisfied with the improved process than Enhanced SNFs. Field notes revealed that corporate willingness to make process changes impacted the Standard group's capacity for change; both groups were heavily influenced by external forces, and turnover was an impediment to RED implementation.

Conclusion: This research revealed that discharge processes are similar across settings and that evidence-based programs such as RED can be adapted to the SNF setting.