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Fine-Tuning the Discharge Process


 

The first metrics from SHM's Project BOOST mentorship program won't be ready until later this year, but the recent addition of more intervention sites comes as pilot institutions are reporting success in changing the discharge culture.

SHM recently announced 24 new sites for Project BOOST (Better Outcomes for Older Adults through Safe Transitions), bringing the number of participating institutions to 30. Each site features SHM mentors working with hospitalists to improve transitional care via a discharge planning toolkit.

Emmanuel King, MD, director of the Nurse Practitioner Hospitalist Service at the Hospital of the University of Pennsylvania in Philadelphia, says a major shift is implementing the "7P Risk Scale," a transitional-care checklist. Dr. King says some of his staff initially balked at depression screening and questions about health literacy, but when the tools were introduced and the checklist items were embraced, hospitalists felt "included in and comfortable with the process."

"Tweaking it to meet the needs of the team was a great idea," says Dr. King, assistant professor of clinical at UPenn's School of Medicine. "We've been able to get the team to buy in."

Tina Budnitz, MPH, SHM senior advisor for quality initiatives, says some early responses to Project BOOST have been better than expected, especially in the area of follow-up tasks.

"I was expecting people to say they were incredibly time-intensive," Budnitz says. "Some of the hospitalists got back to us and said, 'We think it's a good idea to call every patient, regardless of their risk status.' "

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