Evaluating the Implementation of Project Re-Engineered Discharge (RED) in Five Veterans Health Administration (VHA) Hospitals.
Jt Comm J Qual Patient Saf
; 44(11): 663-673, 2018 11.
Article
in En
| MEDLINE
| ID: mdl-30097383
ABSTRACT
BACKGROUND:
Improving the process of hospital discharge is a critical priority. Interventions to improve care transitions have been shown to reduce the rate of early unplanned readmissions, and consequently, there is growing interest in improving transitions of care between hospital and home through appropriate interventions. Project Re-Engineered Discharge (RED) has shown promise in strengthening the discharge process. Although studies have analyzed the implementation of RED among private-sector hospitals, little is known about how hospitals in the Veterans Health Administration (VHA) have implemented RED. The RED implementation process was evaluated in five VHA hospitals, and contextual factors that may impede or facilitate the undertaking of RED were identified.METHODS:
A qualitative evaluation of VHA hospitals' implementation of RED was conducted through semistructured telephone interviews with personnel involved in RED implementation. Qualitative data from these interviews were coded and used to compare implementation activities across the five sites. In addition guided by the Practical, Robust Implementation and Sustainability Model (PRISM), cross-site analyses of the contextual factors were conducted using a consensus process.RESULTS:
Progress and adherence to the RED toolkit implementation steps and intervention components varied across study sites. A majority of contextual factors identified were positive influences on sites' implementation.CONCLUSION:
Although the study sites were able to tailor and implement RED because of its adaptability, redesigning discharge processes is a significant undertaking, requiring additional support/resources to incorporate into an organization's existing practices. Lessons learned from the study should be useful to both VHA and private-sector hospitals interested in implementing RED and undertaking a care transition intervention.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Discharge
/
Quality Improvement
/
Hospitals, Veterans
Type of study:
Clinical_trials
/
Evaluation_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Aspects:
Implementation_research
Limits:
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Jt Comm J Qual Patient Saf
Journal subject:
SERVICOS DE SAUDE
Year:
2018
Document type:
Article