Project Boost at Queen's Medical Center: Looking Into the Future

1Queen's Medical Center, Honolulu, HI

Meeting: Hospital Medicine 2011, May 10-13, Dallas, Texas.

Abstract number: 201

Background:

Project BOOST (Better Outcomes for Older Adults through Safe Transitions) is a Society of Hospitalist Medicine project aimed at improving the care of patients as they transition from hospital to home. Queen's Medical Center (QMC) was 1 of 6 institutions selected to participate in Project BOOST's pilot mentoring program, starting in September 2008. A 28‐bed hospitalist floor is the current site of the project.

Purpose:

(1) To reduce 30‐day readmission rates for general medicine patients; (2) to improve facility patient satisfaction scores; (3) to improve the institution's Hospital Care Quality Indicators from the Consumer Perspective scores related to discharge; (4) to improve flow of information between hospital and outpatient physicians; (5) to ensure high‐risk patients are identified and specific interventions are offered to mitigate their risk; (6) to improve patient and family education practices to encourage use of the teach‐back process around risk‐specific issues

Description:

More than 80% of hospitalists’ patients fall in the high‐risk category at discharge. Therefore, Project BOOST initiatives were applied to all patients. Process mapping of the discharge process identified high‐risk areas of the process to focus on. In addition to standard medication reconciliation at QMC, a designated registered nurse (RN) verifies medications by calling a patient's primary care provider (PCP) and places a corrected list in the electronic medical records (EMR). The attending hospitalist is called if a discrepancy is noted in high‐risk medications. Two RNs regularly perform postdischarge phone calls to patients focusing on ensuring reliable follow‐up as well as compliance with crucial and high‐risk medications, with intervention if needed. A Discharge Writer (the patient's discharge instructions from EMR) is faxed to the PCP in addition to the discharge summary dictated by the hospitalists. A partnership was developed with a QMC primary care clinic to ensure that 100% of patients without a primary care provider had follow‐up appointments prior to discharge. Given the high prevalence of patients with diabetes, members of the diabetes care team were included in the Project BOOST team to help develop tools for patients as well as to educate physicians and nursing staff. To encourage patients’ active participation in the discharge process, an interactive brochure, “Hospital to Home—I Am Ready,” was developed and is currently being optimized. Unmet needs are a full‐time pharmacist and a nurse educator

Conclusions:

Over a 2‐year period of Project BOOST implementation at QMC trends were noted toward decrease length of stay and decrease readmission rate. The needs for a more robust patient education structure and for additional pharmacy support were identified. Plans are currently under way to seek additional funding and to expand Project BOOST to all medicine patients at QMC.

Disclosures:

M. Roytman ‐ Queen's Medical Center, employment; R. Honda ‐ Queen's Medical Center, employment

To cite this abstract:

Roytman M, Honda R. Project Boost at Queen's Medical Center: Looking Into the Future. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 201. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/project-boost-at-queens-medical-center-looking-into-the-future/. Accessed July 22, 2019.

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