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Journal of Aging Research
Volume 2014, Article ID 873043, 5 pages
Research Article

Following Up on Clinical Recommendations in Transitions from Hospital to Nursing Home

1Boston University Geriatric Services, Boston University School of Medicine, Boston Medical Center, 88 East Newton Street, Robinson 2, Boston, MA 02118, USA
2Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), New England VA Healthcare System, 150 South Huntington Avenue, Boston, MA 02130, USA

Received 20 September 2013; Revised 6 December 2013; Accepted 24 December 2013; Published 9 February 2014

Academic Editor: Marja J. Aartsen

Copyright © 2014 Lisa B. Caruso et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Following up on recommendations made at the time of a hospital discharge is important to patient safety. While data is lacking, specifically around the transition of patient to nursing home, it has been postulated that missed items such as laboratory tests may result in adverse patient outcomes. To determine the extent of this problem, a retrospective cohort study of subjects discharged from an academic medical center and admitted to nursing homes (NH) was followed to determine the type of discharge recommendations and the rate of completion. In addition, for the purpose of generalizability, the 30-day hospital readmission rate was calculated. 152 recommendations were made on 51 subjects. Almost a quarter of the recommendations made by the hospital discharging team were not acted upon. Furthermore, for the majority of those recommendations that were not acted upon, a reason could not be determined. In concert with national data, 20% of the subjects returned to the hospital within 30 days. Further investigation is warranted to determine if an association exists between missed recommendations and hospital readmission from the nursing home setting.