What Are Nursing Facilities Doing to Reduce Potentially Avoidable Hospitalizations?
OBJECTIVE
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.


METHODS
Cross-sectional survey.


METHODS
236 nursing facilities from 7 states.


METHODS
Nursing facility administrators.


METHODS
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.
RTI International, Waltham, MA. Electronic address: lcoots@rti.org.
Laura Coots
LC
Daras
RTI International, Waltham, MA.
Joyce M
JM
Wang
RTI International, Waltham, MA.
Melvin J
MJ
Ingber
RTI International, Waltham, MA.
Catherine
C
Ormond
Carnegie Mellon University, Pittsburgh, PA.
Nathaniel W
NW
Breg
RTI International, Waltham, MA.
Galina
G
Khatutsky
RTI International, Waltham, MA.
Zhanlian
Z
Feng
D003430:Cross-Sectional Studies; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D009735:Nursing Homes; D058996:Quality Improvement / Q000592:standards*; D011787:Quality of Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States
Nursing facilities; avoidable hospitalizations; hospitalizations; quality improvement programs