Abstract
Objectives
Hospitalizations among nursing facility residents are frequent and often potentially
avoidable. A number of initiatives and interventions have been developed to reduce
excessive hospitalizations; however, little is known about the specific approaches
nursing facilities use to address this issue. The objective of this study is to better
understand which types of interventions nursing facilities have introduced to reduce
potentially avoidable hospitalizations of long-stay nursing facility residents.
Design
Cross-sectional survey.
Setting
236 nursing facilities from 7 states.
Participants
Nursing facility administrators.
Measurements
Web-based survey to measure whether facilities introduced any policies or procedures
designed specifically to reduce potentially avoidable hospitalizations of long-stay
nursing facility residents between 2011 and 2015. We surveyed facilities about seven
types of interventions and quality improvement activities related to reducing avoidable
hospitalizations, including use of Interventions to Reduce Acute Care Transfers (INTERACT)
and American Medical Directors Association tools.
Results
Ninety-five percent of responding nursing facilities reported having introduced at
least one new policy or procedure to reduce nursing facility resident hospitalizations
since January 2011. The most common practice reported was hospitalization rate tracking
or review, followed by standardized communication tools, such as Situation, Background,
Assessment, Recommendation (SBAR). We found some variation in the extent and types
of these reported interventions.
Conclusions
Nearly all facilities surveyed reported having introduced a variety of initiatives
to reduce potentially avoidable hospitalizations, likely driven by federal, state,
and corporate initiatives to decrease hospital admissions and readmissions.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Rehospitalizations among patients in the Medicare fee-for-service program.N Engl J Med. 2009; 360: 1418-1428
- Identifying potentially preventable readmissions.Health Care Financ Rev. 2008; 30: 75-91
- Proportion of hospital readmissions deemed avoidable: A systematic review.CMAJ. 2011; 183: E391-E402
- The revolving door of rehospitalization from skilled nursing facilities.Health Aff (Millwood). 2010; 29: 57-64
Medicare Payment Advisory Commission (MedPAC). Report to the Congress: Promoting greater efficiency in Medicare. Washington, DC: MedPAC; June 2007.
- Predictors of nursing home hospitalization: A review of the literature.Med Care Res Rev. 2008; 65: 3-39
- Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents 2016.2016 (Available at:) (Accessed November 29, 2016)
- The impact of nursing home pay-for-performance on quality and Medicare spending: Results from the nursing home value-based purchasing demonstration.Health Serv Res. 2016 Aug 4; (Epub ahead of print])
- Pay-for-performance in nursing homes.Health Care Financ Rev. 2009; 30: 1-13
- The Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program: An overview for medical directors and primary care clinicians in long term care.J Am Med Dir Assoc. 2014; 15: 162-170
Article info
Publication history
Published online: March 23, 2017
Footnotes
This project was funded by the Centers for Medicare and Medicaid Services under contract no. HHSM-500-2010-00021I. The statements contained in this paper are solely those of the authors and do not necessarily reflect the views or policies of the Centers for Medicare and Medicaid Services. The authors assume responsibility for the accuracy and completeness of the information contained in this paper.
The authors declare no conflicts of interest.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
