Testing the Re-Engineered Hospital Discharge

Partnerships in Implementing Patient Safety (PIPS)

Brian Jack, M.D.; Boston Medical Center, MA AHRQ Grant No. HS015905-01


This project re-engineered the process of discharging patients from a hospital back into the community to make the process safer. The discharge workflow was redesigned using a set of discrete, mutually reinforcing components that aim to reduce post-discharge adverse events and subsequent re-hospitalizations. Two features of the re-engineered process are a discharge advocate who works with patients throughout the process, and the real time production of a simple, easy to understand discharge plan. The toolkit includes:

  • A discharge manual and software program.
  • A discharge advocate training manual and instructions.
  • Patient education materials.
  • Guidelines for medication reconciliation and for developing a discharge plan for patients.
  • Instructions for telephone re-enforcement of the discharge plan.

Target Audience

Physicians, nurses, pharmacists, patients, caregivers.

Health Care Setting

Hospital care units.

Toolkit Web Site


AHRQ Products

Taking Care of Myself: A Guide for When I Leave the Hospital

Project RED (Re-Engineered Discharge) Training Program

The Project RED (Re-Engineered Discharge) training program is designed to help hospitals re-engineer their discharge process. Using the study modules and supporting materials, hospitals will become familiar with Project RED's processes and components, determine metrics for evaluating impact, and learn how to implement Project RED.

Press Releases

AHRQ Awards More Than $8 Million To Further Implementation of Evidence-Based Patient Safety Findings
June 8, 2005

Presentation Slides

Project RED: Reengineering the Hospital Discharge Process
Date: September 15, 2009
Venue: 2009 AHRQ Annual Conference

Testing the Re-Engineered Discharge: Hands-on Health Literacy (Text Version)
Date: September 9, 2008
Venue: 2008 AHRQ Annual Conference

Reducing Avoidable Hospital Readmissions (Health Research & Educational Trust)
Date: June 4, 2010
Venue: Florida Hospital Association Meeting

Journal Articles

Preventing the preventable: reducing rehospitalizations through coordinated, patient-centered discharge processes. Greenwald JL, Jack BW. Prof Case Manag. 2009 May-Jun;14(3):135-40; quiz 141-2.

A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Jack BW, Chetty VK, Anthony D, Greenwald JL, Sanchez GM, Johnson AE, Forsythe SR, O'Donnell JK, Paasche-Orlow MK, Manasseh C, Martin S, Culpepper L. Ann Intern Med. 2009 Feb 3;150(3):178-87.

Impact Case Studies

Society of Hospital Medicine — Posted July 2010

Frequently Asked Questions

Implementing Re-Engineered Hospital Discharges (Project RED)— Frequently Asked Questions

Return to Contents

Current as of October 2004
Internet Citation: Testing the Re-Engineered Hospital Discharge : Partnerships in Implementing Patient Safety (PIPS). October 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/pips/jack.html