NIH Record - National Institutes of Health

Bowles Discusses Innovations to Improve Discharge Planning

Dr. Bowles with plaque presented by Dr. Grady
Dr. Kathryn Bowles (l) and NINR director Dr. Patricia Grady

Dr. Kathryn Bowles recently presented the first NINR Director’s Lecture of 2016. NINR director Dr. Patricia Grady noted that Bowles’ research combines both her basic research and clinical knowledge, as well as trends in data science and electronic health records, while focusing on “what comes after we do the research? What happens now? How can we maximize the impact?”

In her talk “Innovations to Improve Discharge Planning,” Bowles said her research began as a clinical question about planning for hospital discharge and led to a successful software company that assists health care providers in their decision-making process.

In her roles as director of the Center for Integrative Science in Aging at the University of Pennsylvania School of Nursing and vice president and director of the Center for Home Care Policy and Research at the Visiting Nurse Service of New York, Bowles emphasized that her goal is to “get the right care for the right patients, at the right time, in the right place.”

Early in her career, Bowles built on the research of her mentor, Dr. Mary Naylor, who created and tested the advanced practice nurse-led transitional care model with patients at high risk of poor discharge outcomes. To learn whether patients were being referred to “the right care at the right time,” Bowles asked a panel of experts to review records for high-risk patients who had not been referred for post-acute care and make their own recommendations. Her research showed that of those classified by the expert panel as “high-priority” for home care—but who did not get care—half had been re-hospitalized after discharge.

Bowles and her team conducted additional research to help identify some of the reasons for the lack of referrals, hoping to build a tool to provide decision-making support for health care providers as they planned for patient discharge. This research led to development of the Discharge Decision Support System.

Working with the University of Pennsylvania’s Center for Technology Transfer, Bowles and CEO Eric Heil co-founded a technology company to bring the decision-making tool to market. With a combination of funding from sources such as NINR R01s, SBIR grants and venture capital, RightCare Solutions was launched.

Continuing studies of the electronic decision-making tool have shown that its use helps reduce readmission rates, particularly among high-risk patients. The software is now in use at 34 hospitals in 8 states across the U.S.

Bowles has continued her research into discharge planning, expanding it to include the types of services patients should be referred to upon discharge, interventions for those who refuse referrals and referrals from emergency departments.

The video of her talk is available at https://www.youtube.com/watch?v=zB2dAudmCvA.

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