Project BOOST — Better Outcomes for Older adults through Safe Transitions — reduced readmissions 13.6 percent, according to a study in Journal of Hospital Medicine. However, two accompanying editorials suggest that flaws in the study attenuate these results.
Eleven hospitals implemented Project BOOST, which consists of a series of tools, including an admission risk assessment, discharge readiness checklist and follow-up phone calls, supported by an external quality improvement physician mentor. After 12 months, the average 30-day readmission rate decreased from 14.7 percent to 12.7 percent, a reduction of 13.6 percent. Control units had stable readmission rates, at 14 percent at baseline and 14.1 percent 12 months later. The authors concluded, "Participation in Project BOOST appeared to be associated with a decrease in readmission rates."
However, two accompanying editorials point out flaws in the study that suggest the 13.6 percent readmission reduction is not robust. An editorial by Andrew Auerbach, MD, and colleagues notes that many sites in the study dropped out or failed to report data and the study did not track the number of patients that received all of the BOOST interventions. Despite the flaws, the authors wrote that the study provides a first step to understanding quality improvement interventions' effect on readmissions.
An editorial by Ashish K. Jha, MD, criticized the fact that 19 of the 30 hospitals in the program did not report data. Dr. Jha also suggested that successful readmission reduction interventions rely on a new business model in which hospitals provide social support for patients as they transition out of the hospital.
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