AHRQ releases revised discharge toolkit aimed at curbing readmissions

The Agency for Healthcare Research and Quality released a revised toolkit hospitals can use to lower their rates of preventable readmissions, particularly among patients with limited English proficiency and patients from diverse backgrounds.

The Re-Engineered Discharge Toolkit is based on Project RED, or Re-Engineered Discharge, a 12-step intervention developed at Boston University Medical Center, which incorporates medication reconciliation, plain-language discharge instructions, patient education and telephone follow-up to improve transitions of care and decrease the likelihood of readmissions.

Project RED also features Louise, a virtual, computer-based patient advocate that provides additional patient education and self-management instructions.

According to AHRQ, the toolkit can help hospitals reduce their readmissions and emergency room visits by as much as 30%.

“One readmission or ED visit was prevented for every seven patients receiving the RED,” AHRQ said in the revised toolkit. “Further, the RED patients cost an average of $412 less in the 30 days following hospital discharge than patients who did not receive the RED. This represents a 33.9% lower observed cost for this group. These results have important implications for quality of care and costs for the more than 38 million hospital discharges each year in the United States.”

AHRQ provided initial funding to Boston University Medical Center researchers, and the agency also contracted with BUMC to fund the development of a scalable toolkit for use by other hospitals. This latest expanded version of that toolkit provides “complete implementation guidance” and addresses “language barriers, cross-cultural issues, and disparities in healthcare communication and trust,” AHRQ said.

The updated version also features five additional tools that were absent from the original intervention, including a post-discharge phone call tool with a sample script and a documentation form, and a tool for administering RED to diverse patient populations.