Evaluating the Implementation of Project Re-Engineered Discharge (RED) in Five Veterans Health Administration (VHA)...

Area of Science:

• Healthcare Management
• Quality Improvement
• Patient Care Transitions

Background:

• Improving hospital discharge is crucial for reducing unplanned readmissions.
• Project Re-Engineered Discharge (RED) shows promise for enhancing care transitions.
• Limited research exists on RED implementation within Veterans Health Administration (VHA) hospitals.

Purpose of the Study:

• To evaluate the implementation process of Project Re-Engineered Discharge (RED) in VHA hospitals.
• To identify contextual factors influencing RED implementation in the VHA.
• To provide insights for future RED and care transition interventions.

Main Methods:

• A qualitative evaluation using semistructured telephone interviews with personnel involved in RED implementation.
• Coding of qualitative data to compare implementation activities across five VHA sites.
• Cross-site analysis of contextual factors guided by the Practical, Robust Implementation and Sustainability Model (PRISM).

Main Results:

• Varied progress and adherence to RED implementation steps and components across sites.
• Most identified contextual factors positively influenced implementation efforts.
• RED's adaptability allowed for tailoring and implementation at study sites.

Conclusions:

• Redesigning discharge processes is a substantial undertaking requiring dedicated support and resources.
• The adaptability of RED facilitated its implementation across different VHA settings.
• Lessons learned can inform both VHA and private-sector hospitals implementing RED or similar interventions.