A key quality measure for many payment systems is a hospital’s rate of preventable readmissions, and the Agency for Healthcare Research and Quality (AHRQ) new Re-Engineered Discharge (RED) Toolkit aims to help institutions improve their numbers.

At Boston University Medical Center, where the toolkit was developed and tested over many years, its standardized discharge process reportedly resulted in 30 percent fewer hospital readmissions and emergency room visits.

RED consists of a set of 12 mutually reinforcing actions that a hospital undertakes during and after the hospital stay to ensure a smooth and effective transition at discharge. These are:

1. Ascertain need for and obtain language assistance.
2. Make appointments for follow-up care before discharge.
3. Plan for the follow-up of results from tests or labs that are pending at discharge.
4. Organize post-discharge outpatient services and medical equipment.
5. Identify the correct medicines and a plan for the patient to obtain them.
6. Reconcile the discharge plan with national guidelines.
7. Teach a written discharge plan the patient can understand.
8. Educate the patient about his or her diagnosis and medicines.
9. Review with the patient what to do if a problem arises.
10. Assess the degree of the patient’s understanding of this plan.
11. Expedite transmission of the discharge summary to clinicians accepting care of the patient.
12. Provide telephone reinforcement of the discharge plan.

The toolkit is available as a download from the government. In addition, hospitals can order copies of the instructional manual from the AHRQ Publications Clearinghouse at AHRQPubs@ahrq.hhs.gov.