Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization

J Hosp Med. 2013 Aug;8(8):421-7. doi: 10.1002/jhm.2054. Epub 2013 Jul 22.


Background: Rehospitalization is a prominent target for healthcare quality improvement and performance-based reimbursement. The generalizability of existing evidence on best practices is unknown.

Objective: To determine the effect of Project BOOST (Better Outcomes for Older adults through Safe Transitions) on rehospitalization rates and length of stay.

Design: Semicontrolled pre-post study.

Setting/participants: Volunteer sample of 11 hospitals varying in geography, size, and academic affiliation.

Intervention: Hospitals implemented Project BOOST-recommended tools supported by an external quality improvement physician mentor.

Methods: Pre-post changes in readmission rates and length of stay within BOOST units, and between BOOST units and site-designated control units.

Results: The average rate of 30-day rehospitalization in BOOST units was 14.7% prior to implementation and 12.7% 12 months later (P = 0.010), reflecting an absolute reduction of 2% and a relative reduction of 13.6%. Rehospitalization rates for matched control units were 14.0% in the preintervention period and 14.1% in the postintervention period (P = 0.831). The mean absolute reduction in readmission rates in BOOST units compared to control units was 2.0% (P = 0.054 for signed rank test comparing differences in readmission rate reduction in BOOST units compared to site-matched control units).

Conclusions: Participation in Project BOOST appeared to be associated with a decrease in readmission rates.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Continuity of Patient Care / standards*
  • Continuity of Patient Care / trends*
  • Humans
  • Patient Readmission / standards*
  • Patient Readmission / trends*
  • Prospective Studies
  • Treatment Outcome