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J Hosp Med. 2013 Aug;8(8):421-7. doi: 10.1002/jhm.2054. Epub 2013 Jul 22.

Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization.

Author information

1
Department of Medicine, Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.

Abstract

BACKGROUND:

Rehospitalization is a prominent target for healthcare quality improvement and performance-based reimbursement. The generalizability of existing evidence on best practices is unknown.

OBJECTIVE:

To determine the effect of Project BOOST (Better Outcomes for Older adults through Safe Transitions) on rehospitalization rates and length of stay.

DESIGN:

Semicontrolled pre-post study.

SETTING/PARTICIPANTS:

Volunteer sample of 11 hospitals varying in geography, size, and academic affiliation.

INTERVENTION:

Hospitals implemented Project BOOST-recommended tools supported by an external quality improvement physician mentor.

METHODS:

Pre-post changes in readmission rates and length of stay within BOOST units, and between BOOST units and site-designated control units.

RESULTS:

The average rate of 30-day rehospitalization in BOOST units was 14.7% prior to implementation and 12.7% 12 months later (P = 0.010), reflecting an absolute reduction of 2% and a relative reduction of 13.6%. Rehospitalization rates for matched control units were 14.0% in the preintervention period and 14.1% in the postintervention period (P = 0.831). The mean absolute reduction in readmission rates in BOOST units compared to control units was 2.0% (P = 0.054 for signed rank test comparing differences in readmission rate reduction in BOOST units compared to site-matched control units).

CONCLUSIONS:

Participation in Project BOOST appeared to be associated with a decrease in readmission rates.

PMID:
23873709
DOI:
10.1002/jhm.2054
[Indexed for MEDLINE]

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