title: Implementation of the Re-Engineered Discharge (RED) toolkit to decrease all-cause readmission rates at a rural community hospital.
abstract: BACKGROUND
  National hospital readmission rates average 19%. One in 5 Medicare patients are readmitted within 30 days of discharge each year, resulting in $17.5 billion in additional costs.
  
  
  OBJECTIVE
  The aim of this quality improvement project was to use the methodology outlined by Joint Commission Resources-Hospital Engagement Network and Project Re-Engineered Discharge (Project RED) to redesign the discharge process, reduce hospital 30-day all-cause readmission rates, and improve patient/family involvement in the discharge process.
  
  
  METHODS
  The methodology of the Joint Commission Resources-Hospital Engagement Network and the Agency for Healthcare Research and Quality Project RED toolkit, the After Hospital Care Plan, and a patient discharge questionnaire were used to incorporate best discharge practices into patient care and evaluate the outcomes of the project. Monthly readmission rates and patient/family involvement in the discharge process were examined for 336 patients discharged from a dedicated 30-bed medical-surgical unit in a rural community hospital over a 4-month period.
  
  
  RESULTS
  During the 4-month project, readmissions were reduced by 32% (rate 7.12); the overall monthly reduction from baseline was 27%, with a 44% reduction from baseline during the previous 6 months. The patient and family perception of their discharge process was positive.
authors: Waynesburg University, Waynesburg, Pennsylvania (Drs Adams, Stephens, and Whiteman, and Mr Kersteen); and Southwest Regional Medical Center, Waynesburg, Pennsylvania (Ms Katruska).
authors: Carol J
authors: CJ
authors: Adams
authors: Kimberly
authors: K
authors: Stephens
authors: Kimberly
authors: K
authors: Whiteman
authors: Hal
authors: H
authors: Kersteen
authors: Jeanne
authors: J
authors: Katruska
mesh_terms: D006764:Hospitals, Community; D006801:Humans; D009936:Organizational Innovation; D010359:Patient Readmission / Q000592:standards* / Q000706:statistics & numerical data*; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D014481:United States; D016270:United States Agency for Healthcare Research and Quality