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Improving the discharge process by embedding a discharge facilitator in a resident team.
Finn KM, Heffner R, Chang Y, et al. J Hosp Med. 2011;6:494-500.

The disturbingly high incidence of readmissions after hospital discharge remains a national policy priority, as many readmissions can be linked to adverse events after discharge. In this study, a nurse practitioner (NP) was assigned to a resident inpatient medical team at a tertiary care hospital, with the specific responsibility of facilitating the discharge process. The NP's responsibilities included arranging follow-up appointments, performing medication reconciliation, and following up on tests pending at discharge. Although NP discharge facilitation achieved improved patient satisfaction with the discharge process, higher rates of timely outpatient follow-up, and improved resident work efficiency, it did not result in fewer readmissions or emergency department visits in the post-discharge period. The complex nature of preventing readmissions is discussed in an AHRQ WebM&M interview with Dr. Eric Coleman.

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Meeting the Joint Commission's 2013 National Patient Safety Goals.
Oakbrook Terrace, IL: The Joint Commission; September 2012. ISBN: 9781599407555.
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