Impact of Reengineered Discharge Toolkit on Patients Undergoing Total Joint Surgeries.

Abstract

Poorly coordinated care transitions account for nearly one fifth of Medicare hospital readmissions within 30 days postdischarge. The primary aim of this pilot project was to determine the impact of the Reengineered Discharge (RED) Toolkit on patient knowledge for self-management, satisfaction with the discharge process, readiness for discharge, discharge time, and 30-day readmission rate following hip or knee joint replacement or revision surgeries. Staff adherence with the RED Toolkit was also measured.Thirty adult patients received the intervention of the RED Toolkit. Patient knowledge for self-management ranged from 85.2% to 92.6%; satisfaction with the discharge process scores increased from 33% to 59.2%; patient readiness for discharge scores increased from 2% to 64%. Discharge times decreased. On average, patients left the unit 5.67 (±2.52) hours after the written discharge order. The all-cause 30-day readmission rate was reduced to 3.3%. Staff achieved a RED Toolkit adherence rate of 86.8%. Findings provide a basis for developing a coordinated discharge planning process.