What Researchers Report About The Impact of Project RED
The article that set off a revolution in re-engineering hospital discharges, the original Project RED publication. Jack et al. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009 Feb 3;150(3):178-87. doi: 10.7326/0003-4819-150-3-200902030-00007. PMID: 19189907; PMCID: PMC2738592.
“The RED intervention decreased hospital utilization (combined emergency department visits and readmissions) within 30 days of discharge by about 30% among patients on a general medical service of an urban, academic medical center. More intervention group participants reported seeing their PCP for follow-up within 30 days and reported higher levels of preparedness for discharge. In addition, the intervention was successful in reducing hospital utilization among participants who frequently used hospital services. These data support implementation of a comprehensive program for hospital discharge among similar hospitals.”
"There is substantial opportunity for improved discharge techniques to enhance the safety and quality of care for patients leaving the hospital. Interventions must be implemented to increase transparency of patient education and understanding, particularly among the interprofessional team to clarify assumptions of each other’s roles. Further studies on effective communication strategies as well as systems redesign that foster patient-centered discharge education are imperative".
"Occurrence of poor care transitions can be reduced with a coordinated, standardized approach to managing patients from hospital to home. A discharge transition program was implemented with a QI team leading the interventions, including the addition of teach-back training for all nursing staff, use of a discharge checklist, and completion of a follow-up telephone call. This program was successful in addressing communication gaps and enabling patients to care better for themselves after discharge".
“Much of HF care after discharge is siloed (e.g., hospital discharge, transitional care services, and HF clinic) and we believe engagement with patients and caregivers to place them at the center of care is essential. Looking across countries with various levels of health integration may naturally show what approaches to post discharge care seem to best promote health outcomes.”
"This systematic review of qualitative findings synthesized barriers and facilitators to implementing peri-discharge interventions for reducing avoidable hospital readmission. Ensuring implementation fidelity, and active participation of patients and caregivers are key to reducing avoidable readmission successfully".
"Understanding hospital readmissions after major surgery is, therefore, important for multiple stakeholders, including the CMS, surgeons, and clinicians caring for older adults, hospitals and hospital administrators, and federal decision-makers who develop and implement health policy."
From the article, "Reducing Readmission of Hospitalized Patients With Depressive Symptoms: A Randomized Trial," Annals of Family Medicine, SE Mitchell et al, 2021.
“This study identifies the relative contributions of the brief cognitive behavioral therapy, self-management, and patient navigation components of RED-D. Each component contributes to the decrease in readmission rates with patient navigation being most effective in the first 30 days.”
"Based on the data collected in this study, it appears that post–Project RED patients had a lower rate of 30-day hospital readmission for HF, decreased all-cause mortality, increased follow-up with PCP appointments attended per post discharge instructions, and higher cost saving. While primary outcome of 30-day readmission was not statistically significant, it may still be of clinical significance in practice".
From the article, "Project RED Impacts Patient Experience," Journal of Patient Experience, R. Cancino et al. 2017.
“Our analysis shows that those patients who received the RED intervention at an urban academic safety-net hospital scored significantly higher on the Press Ganey Inpatient Survey item “Instructions given about how to care for yourself at home” as compared to patients who did not receive the intervention.”
From the article, "Implementation and adaptation of the Re-Engineered Discharge (RED) in five California hospitals: a qualitative research study," BMC Health Services Research, SE Mitchell et al, 2017.
“The sustainability of RED in participating hospitals was only possible when hospitals approached RED implementation as a transformational process rather than a patient safety project, maintained a high level of fidelity to the RED protocol, and had leadership and an implementation team who embraced change and failure in the pursuit of better patient care and outcomes.”
From the article, "Project ReEngineered Discharge (RED) Lowers Hospital Readmissions of Patients Discharged From a Skilled Nursing Facility," Journal of the American Medical Directors Association, R. Berkowitz et al, 2013.
“Project RED was successfully adapted and implemented in an SNF and lowered the rate of hospitalization within 30 days of discharge from the SNF from 18.9% to 10.2%. Patients reported seeing their outpatient providers more frequently within 30 days of discharge from the SNF. Patients also reported a higher level of preparedness for discharge.”