Project BOOST: Effectiveness of a multihospital effort to reduce rehospitalization

Hansen, Luke O.; Greenwald, Jeffrey L.; Budnitz, Tina; Howell, Eric; Halasyamani, Lakshmi; Maynard, Greg; Vidyarthi, Arpana R.; Coleman, Eric A.; Williams, Mark

doi:10.1002/jhm.2054

Cited by 236 publications

(203 citation statements)

References 19 publications

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“…[66][67][68][69][70] These efforts have largely occurred in parallel, but now some important bridging QI interventions (eg, collaborative root cause analyses for patients readmitted after PAC) are starting at some sites, and these may drive improvement across the care spectrum. 45 The Society of Hospital Medicine, the AGS, and the AMDA have written White Papers on care transitions that may serve as starting points for discussion.…”

Section: Opportunities For Hospitalists Improve Hospital and Transitimentioning

confidence: 99%

Post–Acute Care Reform: Implications and Opportunities for Hospitalists

Burke

Cumbler

Coleman³

et al. 2017

Journal of Hospital Medicine

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Nearly all practicing hospitalists have firsthand experience discharging patients to post–acute care (PAC), which is provided by inpatient rehabilitation facilities, skilled nursing facilities, or home healthcare providers. Many may not know that PAC is poised to undergo transformative change, spurred by recent legislation resulting in a range of reforms. These reforms have the potential to fundamentally reshape the relationship between hospitals and PAC providers. They have important implications for hospitalists and will open up opportunities for hospitalists to improve healthcare value. In this article, the authors explore the reasons for PAC reform and the scope of the reforms. Then they describe the implications for hospitalists and hospitalists' opportunities to Choose Wisely and improve healthcare value for the rapidly growing number of vulnerable older adults transitioning to PAC after hospital discharge.

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Section: Opportunities For Hospitalists Improve Hospital and Transitimentioning

confidence: 99%

Post–Acute Care Reform: Implications and Opportunities for Hospitalists

Burke

Cumbler

Coleman³

et al. 2017

Journal of Hospital Medicine

Self Cite

View full text Add to dashboard Cite

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“…Since 2012, hospitals have been subject to financial penalties for excessive 30‐day readmissions among patients hospitalized for AMI under the Hospital Readmissions Reduction Program, implemented by the Centers for Medicare and Medicaid Services (CMS). Although federal readmission penalties have incentivized readmissions reduction intervention strategies (known as transitional care interventions), these interventions are resource intensive, are most effective when implemented well before discharge, and have been only modestly successful when applied indiscriminately to all inpatients 5, 6, 7, 8…”

mentioning

confidence: 99%

Predicting 30‐Day Hospital Readmissions in Acute Myocardial Infarction: The AMI “READMITS” (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus , Nonmale Sex , Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score

Nguyen

Makam

Clark

et al. 2018

JAHA

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BackgroundReadmissions after hospitalization for acute myocardial infarction (AMI) are common. However, the few currently available AMI readmission risk prediction models have poor‐to‐modest predictive ability and are not readily actionable in real time. We sought to develop an actionable and accurate AMI readmission risk prediction model to identify high‐risk patients as early as possible during hospitalization.Methods and ResultsWe used electronic health record data from consecutive AMI hospitalizations from 6 hospitals in north Texas from 2009 to 2010 to derive and validate models predicting all‐cause nonelective 30‐day readmissions, using stepwise backward selection and 5‐fold cross‐validation. Of 826 patients hospitalized with AMI, 13% had a 30‐day readmission. The first‐day AMI model (the AMI “READMITS” score) included 7 predictors: renal function, elevated brain natriuretic peptide, age, diabetes mellitus, nonmale sex, intervention with timely percutaneous coronary intervention, and low systolic blood pressure, had an optimism‐corrected C‐statistic of 0.73 (95% confidence interval, 0.71–0.74) and was well calibrated. The full‐stay AMI model, which included 3 additional predictors (use of intravenous diuretics, anemia on discharge, and discharge to postacute care), had an optimism‐corrected C‐statistic of 0.75 (95% confidence interval, 0.74–0.76) with minimally improved net reclassification and calibration. Both AMI models outperformed corresponding multicondition readmission models.ConclusionsThe parsimonious AMI READMITS score enables early prospective identification of high‐risk AMI patients for targeted readmissions reduction interventions within the first 24 hours of hospitalization. A full‐stay AMI readmission model only modestly outperformed the AMI READMITS score in terms of discrimination, but surprisingly did not meaningfully improve reclassification.

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“…National initiatives related to DP have focused on adults (Mitchell et al, 2015), particularly older adults (Gardner et al, 2014, Hansen et al, 2013and Naylor, 2014, with limited focus on pediatric accessed by following the link in the citation at the bottom of the page. Research, Vol 30 (May 2016): pg.…”

mentioning

confidence: 99%

Describing pediatric hospital discharge planning care processes using the Omaha System

Holland

Vanderboom

Delgado

et al. 2016

Applied Nursing Research

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Project BOOST: Effectiveness of a multihospital effort to reduce rehospitalization

Abstract: BACKGROUND: Rehospitalization is a prominent target for healthcare quality improvement and performance-based reimbursement. The generalizability of existing evidence on best practices is unknown.

Cited by 236 publications

References 19 publications

Post–Acute Care Reform: Implications and Opportunities for Hospitalists

Post–Acute Care Reform: Implications and Opportunities for Hospitalists

Predicting 30‐Day Hospital Readmissions in Acute Myocardial Infarction: The AMI “READMITS” (Renal Function, Elevated Brain Natriuretic Peptide, Age, Diabetes Mellitus , Nonmale Sex , Intervention with Timely Percutaneous Coronary Intervention, and Low Systolic Blood Pressure) Score

Describing pediatric hospital discharge planning care processes using the Omaha System

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