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Project BOOST - Better Outcomes by Optimizing Safe Transitions

BOOST Preliminary Results from Pilot Sites

New research published online in the Journal of Hospital Medicine this week finds that hospitals implementing Project BOOST experienced a reduction in 30-day readmissions. Now is the time for hospitalists to do something about it.

In a study of 11 hospitals that implemented one or more Project BOOST tools, hospitals reduced 30-day readmissions by an average of 13.6 percent.

Readmissions are measured by the percentage of hospitalized patients who return to the hospital within 30 days of discharge. The average rate of 30-day readmissions dropped from 14.7 percent before using Project BOOST to 12.7 percent one year afterward.

BOOST Case Studies:

Qualitative Analysis: Barriers and Facilitators to Implementing Project BOOST

Citation: Forth V, Budnitz T, Hansen LO, Greenwald J, Howell E, Halasyamani L, & Williams MV. Barriers and Facilitators to Implementing Project BOOST. Poster presented at: Society of Hospital Medicine Annual Meeting; April 9, 2010; National Harbor, MD.

Click to view the Project BOOST Poster.

Summary of Findings:

  • The unique mentorship element of Project BOOST proved extremely valuable in helping sites overcome their distinctive challenges and identify facilitators for success.
  • Project BOOST appears to be a well-received platform for conducting quality improvement to enhance a hospital’s discharge process.
  • Our findings are consistent with other quality improvement research.

Commonly shared barriers and facilitators among the pilot hospitals included:

  • Magnitude of the difficulty implementing intervention to change the discharge process
  • Too ambitious plans
  • Insufficient hospital leadership support
  • Lack of protected time or dedicated resources
  • Lack of front-line buy-in
  • Inadequate understanding of the current status of the hospital’s discharge process

Commonly shared facilitating factors included:

  • Building teamwork and collaboration
  • Fostering the belief that Project BOOST improves patient care
  • Successful results reinforced the benefits of the effort
  • Starting small and then expanding
  • Mentorship

Project BOOST is based in part on the findings of the earlier SHM care transitions pilot, "Safe Steps"

J Am Geriatr Soc. 2009 Sep;57(9):1540-6. Epub 2009 Aug 18.

A quality improvement intervention to facilitate the transition of older adults from three hospitals back to their homes.

Dedhia P, Kravet S, Bulger J, Hinson T, Sridharan A, Kolodner K, Wright S, Howell E.

PMID: 19694865 [PubMed - indexed for MEDLINE]