Ralph H. Johnson VA Medical Center
Transforming discharge processes for Veterans
Every year millions of patients admitted to the hospital experience complications from post-discharge adverse events, oftentimes leading to a readmission.
The Ralph H. Johnson VA Medical Center is preparing to implement the program Project Re-Engineered Discharge (Project RED) with the goal of reducing Veteran patient readmission and provide a better understanding of the patient’s overall diagnosis and care.
Originally developed through research conducted by Boston University Medical Center and funded by the Agency for Healthcare Research and Quality (AHRQ), Project RED has been proven to reduce re-hospitalizations and yields high rates of patient satisfaction.
According to Wendy Young, project lead at the Charleston VA Medical Center, Project RED will improve coordination and education for Veteran patients starting at admission.
“Starting the discharge process upon admission is essential,” said Young. “As part of this entire program, Veteran patients will receive an after-hospital care plan upon discharge. This will give an overview of their diagnosis, follow-up appointments, and a variety of contact information,” said Young.
Young said the best part about Project RED is that it encourages collaboration across services and with the Veteran.
The Charleston VAMC will host a kick-off event for the Project RED initiative in October.
11 main components of Project RED
1. Educate the patient about his or her discharge throughout the hospital stay.
2. Make appointments for clinician follow-up and post-discharge testing.
3. Discuss with patient any tests or studies that have been completed in the hospital and discuss who will be responsible for following up results.
4. Organize post-discharge services.
5. Confirm the medication plan.
6. Reconcile the discharge plan.
7. Review the appropriate steps for what to do if a problem arises.
8. Expedite transmission of the discharge summary to the physicians (and other services such as the visiting nurses) accepting responsibility for the patient’s care after discharge.
9. Assess the degree of understanding by asking them to explain in their own words the details of the plan.
10. Give the patient a written discharge plan at the time of discharge.
11. Provide telephone reinforcement of the discharge plan and problem–solving two to three days after discharge.