Testing Re-Engineered Discharge Program Implementation Strategies in SNFs

Area of Science:

• Healthcare Management
• Gerontology
• Public Health

Background:

• The Re-Engineered Discharge (RED) program, initially developed for hospitals, is being adapted for skilled nursing facilities (SNFs).
• Reducing hospital readmissions from SNFs is a critical healthcare challenge.
• Understanding the impact of different implementation strategies is essential for effective program adoption.

Purpose of the Study:

• To quantitatively evaluate the effectiveness of two RED program implementation strategies (Enhanced and Standard) in SNFs.
• To compare rehospitalization rates before and after RED implementation.
• To assess the relationship between intervention adoption and patient outcomes.

Main Methods:

• A pretest-posttest design was employed across four Midwestern SNFs.
• Two RED implementation strategies, Enhanced and Standard, were compared.
• Poisson regression analysis was used to adjust for rehospitalization rates at 30, 60, and 180 days.

Main Results:

• The Standard RED group exhibited higher odds of readmission in the pre-intervention period compared to the post-intervention period.
• The adjusted number of rehospitalizations was significantly higher in the pre-intervention period for the Standard group: 45% at 30 days, 50% at 60 days (p=.01), and 39% at 180 days (p=.001).
• The degree of adoption of the SNF RED intervention influenced its benefits.

Conclusions:

• The Re-Engineered Discharge (RED) program is a potentially valuable tool for reducing rehospitalizations from SNFs.
• Effective implementation and high adoption rates of the SNF RED program are crucial for maximizing its benefits.
• Further research into optimizing SNF RED implementation strategies is warranted.