Hospitals Slow to Adopt Readmission-Reducing RED Protocol

Twelve-step process gets cold shoulder

Five years after its launch, the Re-Engineered Discharge (RED) protocol is struggling to catch on in the nation’s hospitals, according to a report from HealthLeaders Media. The creators of the 12-step discharge protocol, which took seven years to compile, say it reduces readmissions and saves money, but it hasn’t been widely adopted.

“What we have seen mostly is hospitals adapting and cherry-picking from a number of different programs,” RED co-creator Suzanne Mitchell, MD, told HealthLeaders senior editor John Commins. “They might take a couple of items from RED and marry them with the Eric Coleman model, which uses a coach that works with patients and caregivers post-discharge."

In fact, even though Mitchell and her Boston University colleagues developed RED, the protocol isn’t widely used at Boston Medical Center.

Mitchell said it’s not uncommon to see three or four readmissions initiatives operating simultaneously at the same hospital.

By design, Mitchell said, the 12 steps identified in the RED protocol are pragmatic and basic, with recommendations that include language assistance when needed, follow-up plans for pending lab results, and providing patients with written discharge plans.

“It’s the same reason why airline pilots use checklists,” Mitchell said. “They want to make sure everything gets done systematically. We feel that everything on the checklist is important and should be done systematically.”

Follow-up studies have shown that problems arise when RED is diluted.

Although RED was designed years before Medicare’s readmissions penalties kicked in, the threat of losing revenues should further incentivize hospitals to adopt aggressive discharge planning. While RED is not the only way to plan discharges, Mitchell said, it is the only protocol that is designated from inside the hospital, which gives hospitals greater control of the process.

Source: HealthLeadersMedia; January 26, 2016.