Patient education program slashes ED readmissions
Patient education program slashes ED readmissions
Patients taught about disease and meds, follow-ups
A new initiative at Boston University Medical Center called the Re-Engineered Hospital Discharge Program (RED) has significantly reduced additional ED visits and readmissions. Thirty days after their hospital discharge, the 370 patients who participated in the RED program had 30% fewer subsequent ED visits and readmissions than the 368 patients who did not.
In addition, 94% of the patients who participated in the program left the hospital with a follow-up appointment with their primary care physician, compared to 35% for patients who did not participate. Also, 91% of the participants had their discharge information sent to their primary care physician within 24 hours of leaving the hospital.
The program used specially trained nurses to help one group of patients arrange follow-up appointments, confirm medication routines, and understand their diagnoses using a personalized instruction booklet. A pharmacist contacted patients two to four days after hospital discharge to reinforce the medication plan and answer any questions.
"Everyone wants patients to be safe and prevent them from coming back to the ED when it may be unnecessary, and giving them the tools they need to take care of themselves when they are home is huge," says discharge nurse Lynn Schipelliti, RN, one of the "discharge advocates" on the project. "This [instruction booklet] is a great tool and reminds us as well to do things that sometimes we as clinicians forget to do," she says.
Brian Jack, MD, head of the project and associate professor and vice chair, clinical director, Lesotho Boston Health Alliance Department of Family Medicine, Boston University School of Medicine/Boston Medical Center, says, "The program is successful because, in a nutshell, we prepare people for discharge and teach them about their diagnosis. We review their meds and how to take them, when their follow-up visit is scheduled, what to do if there's a problem, and then we test their competency."
How is that testing done? "For example, if they have been taught about three or four different medications, we mention one of those drugs and ask them, using a customized booklet we created for them, to show us how many of those pills they take each day," Jack says. This "open-book test" lets the discharge nurse know whether additional education is needed, he explains. The same test can be used, for example, to confirm that the patient knows when, where, and with whom their follow-up appointments will be.
A new initiative at Boston University Medical Center called the Re-Engineered Hospital Discharge Program (RED) has significantly reduced additional ED visits and readmissions. Thirty days after their hospital discharge, the 370 patients who participated in the RED program had 30% fewer subsequent ED visits and readmissions than the 368 patients who did not.Subscribe Now for Access
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