Patient Safety, 2012

Capital Health Influenced by AHRQ's Project RED in Creating Tool for Patients

August 2012

Capital Health, the largest provider of health services in Nova Scotia, Canada, developed a tool for hospital patients that helps organize details about their health status in preparation for discharge. Influenced by AHRQ's Project RED (Re-Engineered Discharge), the tool is designed to encourage better patient flow from admission to discharge.

Linda Benn, RN, BScN, Patient Education Coordinator for Capital Health, says, "Project RED provided the inspiration that led to developing our pilot project. It is simpler than Project RED but has the same goals. Project RED provided proof and support to us that others in the field were moving in this same direction. It made me feel less alone as I developed ours."

Project RED, a toolkit originally developed by AHRQ-funded patient safety researchers in Boston, provides evidence-based tools to help hospitals re-engineer their patient discharge processes. By designating discharge advocates who help patients reconcile their medicines and schedule followup appointments with their primary care physicians, hospitals can reduce avoidable readmissions.

As part of the Capital Health program, Benn is adapting a patient booklet being used elsewhere in Canada. The booklet, "Steps to Home," involves patients more in their discharge planning so they will be better prepared when they leave the hospital. It uses a "traffic light" system to move the patients through various stages of discharge planning, including:

• Stop sign: "Not ready to go home. These are the things I need to know and questions I need to ask."
• Yield sign: "Working on going home, but not quite ready. These are the things I need to know/questions I need to ask."
• Circle with checkmark: "I'm ready to go home or move to a different level of care, such as a skilled nursing facility. These are the things I need to know and do."

The last page of "Steps to Home" is a journal where patients note their progress toward discharge. Some of the questions patients are encouraged to think about prior to discharge include: "What are my medicines?" and "Who do I call if need help after I get home?" Matching symbols are posted over the patient's bed as they progress through the steps to discharge.

Capital Health provides health programs and services to nearly half a million Nova Scotians. As one of 17 Academic Health Sciences Networks across Canada, Capital Health provides critical, trauma, and specialized care to residents throughout Atlantic Canada.

Impact Case Study Identifier: CQuIPS-12-10
AHRQ Products: Partnerships in Patient Safety, Project RED
Topic(s): Emergency Medicine, Quality
Scope: Canada

Greenwald JL, Denham CR, Jack BW. The hospital discharge: a review of a high risk care transition with highlights of a reengineered discharge process. J Patient Saf 2007;3(2):97-106.

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