title: Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization.
abstract: BACKGROUND
  Rehospitalization is a prominent target for healthcare quality improvement and performance-based reimbursement. The generalizability of existing evidence on best practices is unknown.
  
  
  OBJECTIVE
  To determine the effect of Project BOOST (Better Outcomes for Older adults through Safe Transitions) on rehospitalization rates and length of stay.
  
  
  METHODS
  Semicontrolled pre-post study.
  
  
  METHODS
  Volunteer sample of 11 hospitals varying in geography, size, and academic affiliation.
  
  
  METHODS
  Hospitals implemented Project BOOST-recommended tools supported by an external quality improvement physician mentor.
  
  
  METHODS
  Pre-post changes in readmission rates and length of stay within BOOST units, and between BOOST units and site-designated control units.
  
  
  RESULTS
  The average rate of 30-day rehospitalization in BOOST units was 14.7% prior to implementation and 12.7% 12 months later (P = 0.010), reflecting an absolute reduction of 2% and a relative reduction of 13.6%. Rehospitalization rates for matched control units were 14.0% in the preintervention period and 14.1% in the postintervention period (P = 0.831). The mean absolute reduction in readmission rates in BOOST units compared to control units was 2.0% (P = 0.054 for signed rank test comparing differences in readmission rate reduction in BOOST units compared to site-matched control units).
  
  
  CONCLUSIONS
  Participation in Project BOOST appeared to be associated with a decrease in readmission rates.
authors.affiliation: Department of Medicine, Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
authors.forename: Luke O
authors.initials: LO
authors.lastname: Hansen
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Greenwald
authors.forename: Tina
authors.initials: T
authors.lastname: Budnitz
authors.forename: Eric
authors.initials: E
authors.lastname: Howell
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Halasyamani
authors.forename: Greg
authors.initials: G
authors.lastname: Maynard
authors.forename: Arpana
authors.initials: A
authors.lastname: Vidyarthi
authors.forename: Eric A
authors.initials: EA
authors.lastname: Coleman
authors.forename: Mark V
authors.initials: MV
authors.lastname: Williams
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000592:standards* / Q000639:trends*; D006801:Humans; D010359:Patient Readmission / Q000592:standards* / Q000639:trends*; D011446:Prospective Studies; D016896:Treatment Outcome