Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2008 Aug;23(8):1228-33.
doi: 10.1007/s11606-008-0618-9. Epub 2008 May 2.

Redefining and redesigning hospital discharge to enhance patient care: a randomized controlled study

Richard B Balaban  1 , Joel S Weissman, Peter A Samuel, Stephanie Woolhandler
Affiliations
Randomized Controlled Trial

Redefining and redesigning hospital discharge to enhance patient care: a randomized controlled study

Richard B Balaban et al. J Gen Intern Med. 2008 Aug.

Abstract

Background: Patients are routinely ill-prepared for the transition from hospital to home. Inadequate communication between Hospitalists and primary care providers can further compromise post-discharge care. Redesigning the discharge process may improve the continuity and the quality of patient care.

Objectives: To evaluate a low-cost intervention designed to promptly reconnect patients to their "medical home" after hospital discharge.

Design: Randomized controlled study. Intervention patients received a "user-friendly" Patient Discharge Form, and upon arrival at home, a telephone outreach from a nurse at their primary care site.

Participants: A culturally and linguistically diverse group of patients admitted to a small community teaching hospital.

Measurements: Four undesirable outcomes were measured after hospital discharge: (1) no outpatient follow-up within 21 days; (2) readmission within 31 days; (3) emergency department visit within 31 days; and (4) failure by the primary care provider to complete an outpatient workup recommended by the hospital doctors. Outcomes of the intervention group were compared to concurrent and historical controls.

Results: Only 25.5% of intervention patients had 1 or more undesirable outcomes compared to 55.1% of the concurrent and 55.0% of the historical controls. Notably, only 14.9% of the intervention patients failed to follow-up within 21 days compared to 40.8% of the concurrent and 35.0% of the historical controls. Only 11.5% of recommended outpatient workups in the intervention group were incomplete versus 31.3% in the concurrent and 31.0% in the historical controls.

Conclusions: A low-cost discharge-transfer intervention may improve the rates of outpatient follow-up and of completed workups after hospital discharge.

PubMed Disclaimer

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/archinte.165.16.1842', 'is_inner': False, 'url': 'https://doi.org/10.1001/archinte.165.16.1842'}, {'type': 'PubMed', 'value': '16157827', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16157827/'}]}
    2. Coleman EA, Smith JD, Raha D, Min SJ. Posthospital medication discrepancies: prevalence and contributing factors. Arch Intern Med. 2005;165(16):1842–7. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0002-9343(01)00966-4', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0002-9343(01)00966-4'}, {'type': 'PubMed', 'value': '11790365', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11790365/'}]}
    2. Dudas V, Bookwalter T, Kerr KM, Pantilat SZ. The impact of follow-up telephone calls to patients after hospitalization. Am J Med. 2001;111(9B):26S–30S. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1046/j.1525-1497.2003.20722.x', 'is_inner': False, 'url': 'https://doi.org/10.1046/j.1525-1497.2003.20722.x'}, {'type': 'PMC', 'value': 'PMC1494907', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC1494907/'}, {'type': 'PubMed', 'value': '12911647', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12911647/'}]}
    2. Moore C, Wisnivesky J, Williams S, McGinn T. Medical errors related to discontinuity of care from an inpatient to an outpatient setting. J Gen Intern Med. 2003;18(8):646–51. - PMC - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '12558354', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12558354/'}]}
    2. Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003;138(3):161–7. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PMC', 'value': 'PMC331384', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC331384/'}, {'type': 'PubMed', 'value': '14757670', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/14757670/'}]}
    2. Forster AJ, Clark HD, Menard A, et al. Adverse events among medical patients after discharge from hospital. CMAJ. 2004;170(3):345–9. - PMC - PubMed

Publication types