Project BOOST: Effectiveness of a multihospital effort to reduce rehospitalization

被引：202

作者：

Hansen, Luke O. ^{[1
]}

Greenwald, Jeffrey L. ^{[2
]}

Budnitz, Tina ^{[3
]}

Howell, Eric ^{[4
]}

Halasyamani, Lakshmi ^{[5
]}

Maynard, Greg ^{[3
,6
]}

Vidyarthi, Arpana ^{[7
,8
]}

Coleman, Eric A. ^{[9
]}

Williams, Mark V. ^{[1
]}

机构：

[1] Northwestern Univ, Feinberg Sch Med, Div Hosp Med, Dept Med, Chicago, IL 60611 USA

[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Med,Inpatient Clinician Educ Serv, Boston, MA USA

[3] Soc Hosp Med, Philadelphia, PA USA

[4] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA

[5] St Joseph Mercy Hlth Syst, Ypsilanti, MI USA

[6] Univ Calif San Diego, Dept Med, San Diego Sch Med, San Diego, CA 92103 USA

[7] SingHealth, Healthcare Leadership Coll, Singapore, Singapore

[8] Duke NUS Grad Med Sch, Singapore, Singapore

[9] Univ Colorado, Dept Med, Denver, CO USA

来源：

JOURNAL OF HOSPITAL MEDICINE | 2013年 / 8卷 / 08期

关键词：

PATIENTS AFTER-DISCHARGE; QUALITY IMPROVEMENT; ADVERSE EVENTS; PATIENT SAFETY; CARE; CONTINUITY; PROGRAM; SCIENCE;

D O I：

10.1002/jhm.2054

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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. DESIGN: Semicontrolled pre-post study. SETTING/PARTICIPANTS: Volunteer sample of 11 hospitals varying in geography, size, and academic affiliation. INTERVENTION: 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. (C) 2013 Society of Hospital Medicine

引用

页码：421 / 427

页数：7

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