BOOST helps reduce readmissions

July 22, 2013 in Medical Technology

A new study published Monday in the Journal of Hospital Medicine found the Project BOOST (Better Outcomes by Optimizing Safe Transitions) Mentoring Program is effective in  identifying patients at highest risk for readmissions, communicating discharge plans effectively and ensuring close follow-up through phone calls and timely doctors’ appointments.

Developed by the Society of Hospital Medicine,  an integral component to the project is the use of physician mentors to facilitate implementation of BOOST tools at participating hospitals, society officials said in a news release. 


[See also: 3 hospitals go for big change.]


To assess the effectiveness of BOOST, researchers studied hospitals varying in geography, size, and academic affiliation. While 30 hospitals had implemented the program when the study was initiated, only 11 were able to provide hospital unit–specific data for the study. Hospitals received no funding to participate in BOOST.


The investigators found that the average rate of 30 day rehospitalization in BOOST units was 14.7 percent prior to implementing the program and 12.7 percent 12 months later, reflecting an absolute reduction of 2 percent and a relative reduction of 13.6 percent, according to the study.


Rehospitalization rates for similar hospital units that did not implement BOOST were 14.0 percent in the pre-intervention period and 14.1 percent in the post-intervention period. The average absolute reduction in readmission rates in BOOST units compared with other units was 2.0 percent, or a nearly 14 percent relative reduction.


“Our findings support that among the sites willing and able to share the outcome data required for the study, there was significant improvement,” said lead BOOST analyst Luke Hansen, MD, of the Northwestern University Feinberg School of Medicine. “There is more work to do to fully engage non-academic sites in quality improvement research like ours and to understand what makes for fertile ground for implementing changes included in the BOOST toolkit.”


“We are encouraged by our initial findings and learned substantially from this initial implementation and evaluation,” added BOOST principal investigator, Mark V. Williams, MD, of the Northwestern University Feinberg School of Medicine. “Subsequent Project BOOST collaboration with greater than 130 hospitals has been modified and bolstered to increase the intensity of the BOOST intervention,” he said.


In an accompanying editorial, Ashish Jha, MD, of the Harvard School of Public Health, noted that the study’s findings suggest only a small improvement among a very select group of hospitals. “Hospitals will need to find ways to reduce readmissions, and programs like BOOST, even when executed perfectly, will be necessary but likely insufficient. Improving the quality of care transitions is critically important. But to truly get to better outcomes for older Americans, hospitals will need to think beyond their four walls,” he wrote.


[See also: 2013 Best Hospital IT Departments program names 83 finalists.]



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