Re-Engineered Discharge (RED)

Re-engineered discharge (RED) toolkit for inpatient facilities

  • RED is an effective approach to good discharge planning that can significantly lower the incidence of readmissions. This toolkit was originally developed by the Boston University Medical Center with support from the Agency for Healthcare Research and Quality (AHRQ), and this approach can be used with any diverse population. There are 12 key components of RED that make this discharge method successful. The toolkit focuses on all the components.
  • From 2017 – 2020, the Capital Area Behavioral Health Collaborative (CABHC) and PerformCare worked closely with both Pennsylvania Psychiatric Institute and WellSpan Philhaven to replicate this approach, and both hospitals were successful in lowering their readmission rate well below the goal of 10% or less.
  • PerformCare encourages all mental health inpatient facilities to review this toolkit and incorporate this approach. Permission was given to download the RED toolkit (PDF) for your use. You can also visit the AHRQ website, which provides additional tools, such as templates, workbooks, and case studies.
  • If your facility is interested in a training, or if you have questions about the components, please contact your Account Executive and someone from Quality will reach out to you.

RED for other behavioral health providers

The Agency for Healthcare Research and Quality (AHRQ) designed a whole-person transition care toolkit with evidence-based strategies to reduce hospital readmissions. Although the RED toolkit was developed to reduce hospital readmissions, the toolkit focuses on good discharge planning standards that apply to all levels of care.

Key components of good discharge standards*

  1. Have a specific policy and procedure documented for staff to review.  
  2. Notify the patient of the plans for discharge early in treatment. Avoid last-minute discharges that do not have all the plans completed. 
  3. Speak directly with other outpatient behavioral health providers involved in the patient's care about the discharge plans. Communicate with other providers before the day of discharge. 
  4. Identify social determinants of health that may interfere with the patient’s recovery. Outreach to community and social agencies earlier in treatment.
  5. Have a hard copy of discharge plans to provide the patient and ensure it is in easy-to-read language. 
  6. Be aware that patients who have a limited ability to speak English or have limited health literacy may need assistance with understanding discharge plans. Take appropriate action steps to assist the patient in reviewing the plan. 
  7. Use the teach-back method when reviewing any materials. If you are unsure what the teach-back method is, go to Tool 5 in the RED toolkit.
  8. Recommend and encourage the patient to talk to their primary care provider about their current behavioral health medications and to check if they have all their preventive care needs met. Because the patient may need assistance with this call, this could be done while the patient is still in treatment. 
  9. Engage family members, caregivers, or designated supports in the plans for discharge. Ensure any follow-up plans are acceptable to them, especially if they are providing transportation. 
  10. Review your processes periodically and update as needed.

*Adapted from the RED toolkit

https://www.ahrq.gov/patient-safety/settings/hospital/red/toolkit/index.html

Providers