What does this research mean for the field?

A multi-component discharge planning intervention toolkit for hospitalized older adults significantly improves the quality of care transitions and reduces 30-day readmission rates and early returns to the emergency department. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

August 18, 2009Journal of the American Geriatrics Society

A Quality Improvement Intervention to Facilitate the Transition of Older Adults from Three Hospitals Back to Their Homes

Q: What is the clinical evidence from this study?

Population: Hospitalized older adults (n=422). Intervention: Discharge planning intervention toolkit vs. Preintervention period. Primary outcome: Thirty-day readmission (OR 0.59, 95% CI 0.34-0.97).

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Key result

A discharge planning intervention toolkit for hospitalized older adults reduced 30-day readmission rates from 22% to 14% (OR 0.59; 95% CI 0.34-0.97).

Why the study?

Does a discharge planning intervention toolkit reduce 30-day readmissions and emergency department returns in hospitalized patients aged 65 and older?

Structured PICO

Does a discharge planning intervention toolkit reduce 30-day readmissions and emergency department returns in hospitalized patients aged 65 and older?

Population

422 patients aged 65 and older admitted to the hospitalist services at general medicine wards across three hospitals (237 in preintervention period, 185 in intervention period).

Intervention

Discharge planning intervention toolkit consisting of five core elements: admission form with geriatric cues, facsimile to the primary care provider, interdisciplinary worksheet to identify barriers to discharge, pharmacist-physician collaborative medication reconciliation, and predischarge planning appointments.

Comparator

Preintervention period (standard care).

Outcome

Thirty-day readmission and return to emergency department rates and patient satisfaction with discharge.hard clinical

Main Result

Effect estimate: OR 0.59 (95% CI 0.34-0.97)

Absolute Event Rate: 14% vs 22%

A structured discharge planning intervention toolkit significantly reduced 30-day readmissions and early emergency department returns among older adults hospitalized on general medicine wards.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports discharge planning toolkits for older adults; hypothesis-generating and requires randomized confirmation before practice change.

Cite This Study

Dedhia et al. (2009) studied Hospitalized older adults (n=422). Discharge planning intervention toolkit vs. Preintervention period was evaluated on Thirty-day readmission (OR 0.59, 95% CI 0.34-0.97). A discharge planning intervention toolkit for hospitalized older adults reduced 30-day readmission rates from 22% to 14% (OR 0.59; 95% CI 0.34-0.97).

synapsesocial.com/papers/6a15b787cb801b7f954ed37e https://doi.org/10.1111/j.1532-5415.2009.02430.x

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A Quality Improvement Intervention to Facilitate the Transition of Older Adults from Three Hospitals Back to Their Homes

Structured PICO

Main Result

Discussion

Implication

Cite This Study

A Quality Improvement Intervention to Facilitate the Transition of Older Adults from Three Hospitals Back to Their Homes

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider