Re-engineering Skilled Nursing Facility Discharge: Analysis of RED Implementation

Abstract

Background:

There is a need to adopt evidence-based approaches to discharge planning in the Skilled Nursing Facility (SNF) short stay population.

Purpose:

To describe implementation of Re-engineered Discharge (RED) Process in SNFs and makes recommendations for its future implementation.

Methods:

Pre and post analysis of an 18-month RED implementation with a contemporaneous comparison of 4 Midwestern SNFs randomly assigned to two different RED implementation strategies; Standard facilities received less implementation than Enhanced facilities.

Results:

Standard SNFs made more improvements and were more satisfied with the improved process than Enhanced SNFs. Field notes revealed corporate willingness to make process changes impacted the Standard group’s capacity for change; both groups were heavily influenced by external forces and turnover was an impediment to RED implementation.

Conclusion:

This research revealed that discharge processes are similar across settings and that evidence-based programs such as RED can be adapted to the SNF setting.