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Quality Improvement  
Exchange Information Implementation Guide Professional Development Resource Room Project Team Main Resource Room Home Heart Failure Resource Room

Overview

The BOOSTing (Better Outcomes by Optimizing Safe Transitions) Care Transitions resource room provides a wealth of materials to help you optimize the discharge process at your institution. We developed this through support from the John A. Hartford Foundation (Read more about Project BOOST and the BOOST mentoring program) . We based the approach and tools on principles of quality improvement, evidence-based medicine as well as personal and institutional experiences. Of note, we are piloting the contents at multiple hospitals and will be constantly revising the resource room based on this invaluable experience.

This resource room will help you to:

  • Analyze current workflow processes
  • Select effective interventions
  • Redesign work flow and implement interventions
  • Educate your team on best practices
  • Promote a team approach to safe and effective discharges
  • Evaluate your progress and modify your interventions accordingly

Each section of this resource is described below. 

You will also have access to:

Why Should You Act?

  • Hospitalists, by definition, introduce discontinuity in care as patients transition from outpatient provider, to the hospital medicine service, and then back to outpatient provider.
  • Inadequately performed care transition can lead to multiple negative consequences such as decreased patient understanding, medication errors, increased stress on the caregiver, increased readmission rates, and an increase in care costs.
  • Collaboration between health care providers has been shown to improve these outcomes, as well as patient satisfaction and quality of life.

1Coleman, E, Parry, C, et, al. The care transitions intervention: a patient-centered approach to ensuring effective transfers between sites of geriatric care. Home Health Care Serv Q 2003; 22(3):1-17. PMID: 14629081

2Simon, SR, Lee, TH, et, al. Communication problems for patients hospitalized with chest pain. J Gen Intern Med. 1998 Dec;13(12):836-8. PMID: 9844081

3van Walraven, c, Mamdani, M, et, al. Continuity of care and patient outcomes after hospital discharge. J Gen Intern Med. 2004 Jun;19(6):624-31. PMID: 15209600

4Preen D, Bailey B, Wright A, et al. Effects of a multidisciplinary, post-discharge continuance of care intervention on quality of life, discharge satisfaction, and hospital length of stay: a randomized controlled trial. Int J Qual Health Care. 2005; Feb 17(1):43-51. PMID: 15668310

5Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA 2007; 297:831-41. PMID: 17327525

6Kripalani S, Jackson AT, Schnipper JL, Coleman EA. Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists. J Hosp Med 2008;2:314-323. PMID: 17935242

Fundamental Principle for Care Transitions

Communication between care providers is an essential part of medical care that influences patients' quality of life and effective disease treatment. Hospitalists can act as leaders to educate both patients and providers regarding appropriate steps to take to improve care transitions, and reduce risks associated with these transitions.

 

 

 

BOOSTing Care Transitions Resource Room Project Team
This resource room is sponsored in part by an unrestricted educational grant from the John A. Hartford Foundation, Inc.

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Disclaimer
The Care Transitions for Older Adults Resource Room is an online resource for visitors to the Society of Hospital Medicine's website. All content and links have been reviewed by the Care Transitions for Older Adults Resource Room Project Team, however the Society of Hospital Medicine does not exercise any editorial control over content associated with the external links that have been made available via this website.
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