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Reengineering Hospital Discharge: A Protocol to Improve Patient Safety, Reduce Costs, and Boost Patient Satisfaction

Implementing patient safety improvements does not often yield immediate cost savings. Yet new research shows a way to reduce hospital readmissions dramatically and save nearly $400 per admission in doing so. Rehospitalization, typically defined as hospital readmission within 30 days of a hospital discharge, is a common, expensive, and lifethreatening event too often associated with gaps in follow-up care. New evidence shows that when hospitals focus on the discharge process, patient care and safety improve and costs decline. Given these advantages, it is difficult to understand why more hospitals have not already overhauled their patient discharge protocols. The answer is counterintuitive: Until recently, properly planned, communicated, and executed hospital discharges have not been a primary focus for hospitals or clinicians. Additionally, the lack of financial incentives attached to patient discharge prevents hospitals from implementing coordinated discharge programs. That could be changing soon, however. As part of President Obama’s 2010 budget plan, Medicare could save an estimated $26 billion by bundling some payments to include follow-up care. Hospitals with high rates of readmission within 30 days would be paid less.