Project BOOST Mentoring Program

Welcome to Project BOOST A National initiative led by the Society of Hospital Medicine with guidance from multidisciplinary leaders and stakeholders across the US to improve the care of patients as they transition from hospital to home

Our Vision

According to recent research published in the New England Journal of Medicine, about 1 in 5 hospitalizations of patients with Medicare were followed by readmissions within 30 days after discharge. These unplanned rehospitalizations cost Medicare $17.4 billion in 2004.

By improving discharge processes, Project BOOST aims to:

• Reduce 30 day readmission rates for general medicine patients (with particular focus on older adults);
• Improve facility patient satisfaction scores;  and institution’s H-CAHPS scores related to discharge;
• Improve the flow of information between hospital and outpatient physicians ;
• Identify high-risk patients and target specific interventions to mitigate their risks for adverse events; and 
• Improve patient and family preparation for discharge
  

Background

Project BOOST is led by a national advisory board of recognized leaders in care transitions and hospital medicine, and includes payers and regulatory agencies. The board is co-chaired by Eric Coleman MD, MPH and Mark Williams, MD, FACP, FHM and includes representatives from the Agency for Healthcare Research and Quality (AHRQ); Blue Cross and Blue Shield Association; Centers for Medicare and Medicaid Services (CMS); Centers for Disease Control and Prevention (CDC); Institute for Health Care Improvement (IHI); The Joint Commission; Kaiser Permanente; medical, pharmacy and nursing professional societies, patient advocates; and many others.

Project BOOST has four key elements:

• A comprehensive intervention based on the best available evidence, validated through a panel of nationally recognized experts.
• A comprehensive BOOST Implementation Guide that provides step by step instructions and project management tools to help multi-disciplinary teams to plan, implement and evaluate the intervention.
• Longitudinal technical assistance.  The BOOST Mentoring Program is provided courtesy of a grant from the John A Hartford Foundation, and includes face to face training and a year of expert mentoring and coaching to reengineer the discharge process and implement BOOST.
• BOOST Collaborative. Sites are able to communicate with and learn from each other via the BOOST Listserv, online community site, and quarterly all-site teleconferences.

Analysis

Preliminary interviews with pilot sites indicate that BOOST tools are well-received by health care teams and patients. Project BOOST has improved communication and collaboration across functions within the hospital and with primary care physicians. Patients have also had a very positive response to what they perceive to be an increase in the level of service and medical attention.

While  an analysis across all sites is not yet complete, preliminary data from pilot sites demonstrated readmission rates in BOOST units fell from 13% to 11% in the six months following the BOOST “go live” date, while similar non-BOOST units experienced a rise in average readmission rates from 11% to 13% over the same interval. Aggregated data, including a full year post intervention, will be available in early 2011.

Timeline

• Sept 2008: SHM selects and implements 6 Project BOOST pilot sites.
• March 2009: The second cohort begins, consisting of 24 nationwide sites. Total BOOST sites: 30
• Jan 2010: Blue Cross Blue Shield Association of Michigan partners with SHM to implement BOOST at 15 Michigan hospitals and expand evaluations to include impact on ED visits.  Total BOOST sites: 45
• May 2010: SHM training session for MI sites, and 2 new tuition based sites. Total BOOST sites: 47
• May 2010: SHM partners with the California HealthCare Foundation to support adding 20 California hospitals to the BOOST collaborative. Total BOOST sites: 65

Funding

Project BOOST was developed through a $1.4M grant from The John A. Hartford Foundation. The collaborative continues through funding from the following programs:

• Blue Cross Blue Shield Association of Michigan and its 15 sites contribute roughly $225,000 to the program.
• The California HealthCare Foundation will contributing roughly $280,000 to partially support tuition for 20 sites.
• Tuition based sites pay $28,000 per site.

Participating Sites by State

Project BOOST now spans across 24 states nationwide.  Below are the states currently included in the collaborative:

Click here to view full listing of BOOST Sites

The Patient Protection and Affordable Care Act

Project BOOST is an effective tool for managing readmissions and transitions of care. The recently passed healthcare reform legislation includes several provisions aimed at reducing readmissions and improving care transitions: 

• Hospital Readmissions Reduction Program (Sec.3025, Sec.10309)
• Health Care Delivery System Research; Quality Improvement Technical Assistance(Sec.3501)
• Community Care Transitions Program (Sec.3026)
• National Strategy for Quality Improvement(Sec.399HH)
• Ensuring the Quality of Care(Individual and Group Market Reforms - Sec.2717)
• Rewarding Quality Through Market-Based Incentives, Enhancing Patient Safety (Health Benefit Exchanges - Sec.1311)

Read What Others Have Experienced With BOOST

• BOOST Case Studies:
• Read about Piedmont Hospital, "BOOSTing a Team Approach to Patient Care
• Read about SSM St. Mary’s Medical Center, "Reducing Readmissions and So Much More"
• Advisory Board statements About BOOST
• BOOST in the Media

Apply Online

For information contact lvalentino@hospitalmedicine.org (267-702-2672)