Increased care capacity in nursing homes has been shown to reduce costly hospital
transfers, however little evidence is available to guide decision making for specific
transfers.
1
Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms:
Transforming Institutional Care (OPTIMISTIC), developed and evaluated through a demonstration
project funded by the US Centers for Medicare & Medicaid Services, a multicomponent
intervention centered around specialized staff, has been successful in reducing hospital
transfers.
2
,- Unroe K.T.
- Nazir A.
- Holtz L.R.
- et al.
The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms:
Transforming Institutional Care approach: preliminary data from the implementation
of a Centers for Medicare and Medicaid Services nursing facility demonstration project.
J Am Geriatr Soc. 2015; 63: 165-169
3
A second phase of the project tested a payment model incentivizing nursing homes
to address 6 conditions identified as major drivers of hospitalization, including
treating urinary tract infections (UTIs) in place, rather than transferring residents
to the hospital, when safe and feasible. We identified characteristics, signs, symptoms,
and treatments of nursing home residents diagnosed with UTI who were treated in place
and compared them to those of hospitalized residents.To read this article in full you will need to make a payment
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References
- Decisions to transfer nursing home residents to emergency departments: A scoping review of contributing factors and staff perspectives.J Am Med Dir Assoc. 2016; 17: 994-1005
- The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.J Am Geriatr Soc. 2015; 63: 165-169
- OPTIMISTIC transition visits: A model to improve hospital to nursing facility transfers.Ann Longterm Care. 2016; 24: 31-36
- Which clinical indicators and resident characteristics are associated with health care practitioner nursing home visits or hospital transfer for urinary tract infections?.J Am Med Dir Assoc. 2006; 7: 493-498
- Mobility and other predictors of hospitalization for urinary tract infection: A retrospective cohort study.BMC Geriatr. 2008; 8: 31
- Which nursing home residents with pneumonia are managed on-site and which are hospitalized? Results from 2 years' surveillance in 14 US homes.J Am Med Dir Assoc. 2020; 21: 1862-1868
- Seeing Sepsis—LTC poster.(Available at:)https://www.mnhospitals.org/Portals/0/Documents/ptsafety/SeeingSepsisLTC/1.%20Seeing%20Sepsis%20-%20LTC%20Poster.pdfDate accessed: April 28, 2020
- A statewide program to improve management of suspected urinary tract infection in long-term care.J Am Geriatr Soc. 2020; 68: 62-69
- A 2-year pragmatic trial of antibiotic stewardship in 27 community nursing homes.J Am Geriatr Soc. 2020; 68: 46-54
- The IOU consensus recommendations for empirical therapy of cystitis in nursing home residents.J Am Geriatr Soc. 2019; 67: 539-545
Article info
Publication history
Published online: August 27, 2021
Footnotes
This project was supported by the ASPIRE program funded by the Indiana University Division of General Internal Medicine and Geriatrics. OPTIMISTIC was supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) [grant 1E1CMS331488]. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, CMS, HHS, or the U.S. Government.
K.U. is the CEO of Probari, a health care start-up founded to disseminate the OPTIMISTIC clinical care model. M.W. is Chief of Health Services Research and Development at the Richard L. Roudebush Veterans Affairs Medical Center in Indianapolis, Indiana. The views expressed in this letter are those of the authors and do not necessarily represent the views of the US Department of Veterans Affairs.
The authors declare no conflicts of interest.
Identification
Copyright
Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
