It's safe to say that few Americans enjoy being treated and retreated at hospitals. However, after patients are discharged, 20 percent of them — often the elderly — suffer complications related to the treatments received and end up in the hospital once again. This is a serious waste of tax dollars, especially for those with Medicare or other government-subsidized health insurances.

Now, new laws — integral to the Affordable Care Act — seek to reduce hospital readmission by improving care and enacting penalties for hospitals with too many readmissions. And so, the race is on to figure out the best ways to reduce readmissions and severe penalties.

In a new study, a team of researchers developed a new program to help hospitals avoid penalties by reducing the possibility of readmission altogether. Project BOOST, or the Better Outcomes for Older adults through Safe Transitions, concentrates on identifying patients at highest risk for readmission, creating effective plans for their gradual release from the hospital after their health is restored, and ensuring close follow-up through phone calls and timely doctors' appointments for check-ups.

Eleven hospitals were part of this two-year study. Each hospital was instructed on how to use the BOOST tools effectively; this included five to six check-up phone calls within a one-year period, as well as check-up visits based on information relayed in those phone calls. Researchers measured each patient's rehospitalization within 30 days of release, along with their length of stay for each time they were admitted.

Researchers found that in the BOOST hospitals, rehopsitalization rate — previously at 15 percent prior to the BOOST program — was reduced by two percent, in comparison with hospitals not participating in the BOOST program. While there was no significant change to the length of each patient's stay in the hospital, the reduction in readmissions altogether is promising.

The ability of a hospital to provide better care and options for post-hospital care is critical for maintaining patient health. The BOOST program offers patients detailed information in order to ensure they can take care of their health after being discharged. This includes the follow-up phone calls previously mentioned, as well as discharge instructions, a discharge readiness checklist, all hospital personal discharge summaries, and admission risk assessments. Each of these tools allow hospitals and medical practitioners to standardize when patients can be safely released.

However, the two-percent decrease in readmissions over the two years of this study are mediocre at best. "Hospitals will need to find ways to reduce readmissions, and programs like BOOST, even when executed perfectly, will be necessary but likely insufficient. Improving the quality of care transitions is critically important. But to truly get to better outcomes for older Americans, hospitals will need to think beyond their four walls," said Ashish Jha, M.D., MPH, of the Harvard School of Public Health.

The findings of this study show promise but simply aren't enough to warrant all hospitals take on only the BOOST program. Instead, hospitals should take on other initiatives, in addition to BOOST. These could include giving patients more options regarding how best to take care of their health, seeking counselors to deal with chronic diseases and disorders, and admitting patients to other facilities should they prove unable to manage their health on their own. The researchers admit it is the responsibility of both patient and hospital to reduce readmissions; readmissions cannot be effectively cut until a concerted effort between both parties is undertaken.

Sources: Hansen LO, Greenwald JL, Budnitz T, et al. Project BOOST: Effectiveness of a Multihopsital Effort to Reduce Hospitalization. Journal of Hospital Medicine. 2013.

Jha AK. BOOST and readmissions: Thinking beyond the walls of the hospital. Journal of Hospital Medicine. 2013.