David C. Grabowski, Joseph G. Ouslander, M.D., Gerri Lamb, Ph.D., R.N., FAAN, Ruth Tappen, Ed.D., FAAN, Laurie Herndon, M.S.N., G.N.P., Sanya Diaz, M.D., Bernard A. Roos, M.D., and Alice Bonner, Ph.D., R.N.
J. G. Ouslander, G. Lamb, R. Tappen et al., "Interventions to Reduce Hospitalizations from Nursing Homes: Evaluation of the INTERACT II Collaborative Quality Improvement Project," Journal of the American Geriatrics Society, April 2011 59(4):745–53.
An intervention designed to identify and manage acute conditions and status changes among nursing home residents resulted in a 17 percent reduction in hospital admissions.
The effect of the intervention is substantial, say the authors. If implemented widely, the program could result in fewer complications, lower morbidity from hospitalizations, and reductions in Medicare costs. In the study, the reductions in hospitalization were achieved despite financial, legal, and regulatory incentives that favor hospitalization over the risks and costs of managing acute illnesses in the nursing home. The projected savings of $125,000 per year would be enough to support a full-time advance practice nurse or physician assistant in the nursing home, as well as the costs of implementing the intervention.
INTERACT II was implemented at 25 community-based nursing homes in Florida, Massachusetts, and New York that were recruited for the project. Data on hospitalization rates were obtained from the nursing homes during the six-month implementation (July 2009–December 2009) and for the corresponding months in 2008. The INTERACT tools and resources are available at http://interact2.net.
The INTERACT II intervention has the potential to decrease hospital admissions among nursing home residents and reduce Medicare costs.