Early Intervention Can Reduce Hospital Admissions Among Nursing Home Residents
Summary of this study. Researchers compared hospital admission rates among nursing home residents before and after the nursing home staff received specialized training on how to avoid hospitalizations using early intervention techniques. They found that nursing home staff who participated in a six-month training program could reduce hospital admission rates by one-fifth, resulting in annual savings of at least $125,000 for the Medicare system. This research is important because hospitalizations are particularly high-risk for nursing home residents, who have increased rates of infection and death while in the hospital.
Why the study was done. This study was designed to see if providing special training and tools such as patient tracking forms to nursing home staff could reduce residents’ hospital admissions. When nursing home residents get sick and enter the hospital, they have a higher risk of infection and death. Their hospitalizations are also quite expensive for the Medicare system. Past studies have found that admission rates among nursing home residents could be reduced if staff was trained to identify and address early warning signs of changes in residents’ health status.
How they did the study. INTERACT II (Interventions to Reduce Acute Care Transfers) is a six-month training program designed to help nursing home staff, primarily nurses and nursing assistants, identify early changes in residents’ health, mental and functional status that could lead to hospitalizations. The training also included interventions staff could use to improve residents’ health and avoid hospitalization. Twenty-five nursing homes in three states completed the program.
What they found. Hospital admissions dropped 17 percent in participating nursing homes compared to the same time period the previous year, and admissions dropped 24 percent in homes that were the most active and engaged in the INTERACT program. That compares to just a 3 percent drop in a group of nursing homes that didn’t participate in the study. Given the number of residents in a 100-bed nursing home who are hospitalized each year, the study findings suggest that implementing the INTERACT II program could result in 25 fewer hospitalizations a year, for an annual savings of $125,000 in Medicare hospital stay costs.
What you can do. “If you or someone you care for is in a nursing home, make sure to speak with the nursing staff about your concerns regarding hospitalization,” said study author Joseph Ouslander, MD. “Ask if there is anything that can be done to identify health problems early, when they can be treated in the nursing home, to help residents stay out of the hospital.”
This study is from the full report titled, Interventions to Reduce Hospitalizations from Nursing Homes: Evaluation of the INTERACT II Collaborative Quality Improvement Project. It is in the April 2011 issue of The Journal of the American Geriatric Society. The report is authored by Joseph G. Ouslander, MD; Gerri Lamb, PhD, RN; Ruth Tappen, EdD; Laurie Herndon, MSN, GNP; Sanya Diaz, MD;Bernard A. Roos, MD;David C. Grabowski, PhD; and Alice Bonner, PhD, RN.