New decision support algorithm improves discharge outcomes

Editor's Note

In this study from the University of Pennsylvania School of Nursing, researchers developed, validated, and tested an algorithm called, “Discharge Referral Expert System for Care Transitions (DIRECT),” which helped clinicians identify patients most in need of post-acute care (PAC) and lowered readmission rates.

The researchers conducted a 4-month control phase of the study without the algorithm on 3,302 patients, followed by a 6-month intervention phase with the algorithm on 5,006 patients.

Though the algorithm recommended 24%-25% more patients for PAC, the proportion of patients receiving PAC referrals did not differ significantly between the two groups.

However, characteristics of patients referred for PAC did differ significantly, and inpatient readmission rates decreased significantly with the algorithm versus without. There were no differences in emergency department visits between the two groups.

Further studies examining the outcomes of these patients may have policy implications, the researchers note.