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Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations.

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Title: Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations.
Authors: Huckfeldt, Peter J., Kane, Robert L., Yang, Zhiyou, Engstrom, Gabriella, Tappen, Ruth, Rojido, Carolina, Newman, David, Reyes, Bernardo, Ouslander, Joseph G.
Source: Journal of the American Geriatrics Society. Sep2018, Vol. 66 Issue 9, p1830-1837. 8p. 1 Diagram, 3 Charts, 1 Graph.
Subjects: Health care intervention (Social services), Medical quality control, Critical care medicine, Hospital care, Hospital emergency services, Medical appointments, Motivation (Psychology), Nursing care facilities, Self-evaluation, Surveys, Secondary analysis, Human services programs, Patient readmissions
Geographic Terms: United States
Abstract: Objectives: To determine whether degree of implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) program is associated with number of hospitalizations and emergency department (ED) visits of skilled nursing facility (SNF) residents. Design: Secondary analysis from a randomized controlled trial. Setting: SNFs from across the United States (N=264). Participants: Two hundred of the SNFs from the randomized trial that provided baseline and intervention data on INTERACT use. Interventions: During a 12‐month period, intervention SNFs received remote training and support for INTERACT implementation; control SNFs did not, although most control facilities were using various components of the INTERACT program before and during the trial on their own. Measurements: INTERACT use data were based on monthly self‐reports for SNFs randomized to the intervention group and pre‐ and postintervention surveys for control SNFs. Primary outcomes were rates of all‐cause hospitalizations, potentially avoidable hospitalizations (PAHs), ED visits without admission, and 30‐day hospital readmissions. Results: The 65 SNFs (32 intervention, 33 control) that reported increases in INTERACT use had reductions in all‐cause hospitalizations (0.427 per 1,000 resident‐days; 11.2% relative reduction from baseline, p<.001) and PAHs (0.221 per 1,000 resident‐days; 18.9% relative reduction, p<.001). The 34 SNFs (12 intervention, 22 control) that reported consistently low or moderate INTERACT use had statistically insignificant changes in hospitalizations and ED visit rates. Conclusion: Increased reported use of core INTERACT tools was associated with significantly greater reductions in all‐cause hospitalizations and PAHs in both intervention and control SNFs, suggesting that motivation and incentives to reduce hospitalizations were more important than the training and support provided in the trial in improving outcomes. Further research is needed to better understand the most effective strategies to motivate SNFs to implement and sustain quality improvement programs such as INTERACT. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations.
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  Data: Objectives: To determine whether degree of implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) program is associated with number of hospitalizations and emergency department (ED) visits of skilled nursing facility (SNF) residents. Design: Secondary analysis from a randomized controlled trial. Setting: SNFs from across the United States (N=264). Participants: Two hundred of the SNFs from the randomized trial that provided baseline and intervention data on INTERACT use. Interventions: During a 12‐month period, intervention SNFs received remote training and support for INTERACT implementation; control SNFs did not, although most control facilities were using various components of the INTERACT program before and during the trial on their own. Measurements: INTERACT use data were based on monthly self‐reports for SNFs randomized to the intervention group and pre‐ and postintervention surveys for control SNFs. Primary outcomes were rates of all‐cause hospitalizations, potentially avoidable hospitalizations (PAHs), ED visits without admission, and 30‐day hospital readmissions. Results: The 65 SNFs (32 intervention, 33 control) that reported increases in INTERACT use had reductions in all‐cause hospitalizations (0.427 per 1,000 resident‐days; 11.2% relative reduction from baseline, p&lt;.001) and PAHs (0.221 per 1,000 resident‐days; 18.9% relative reduction, p&lt;.001). The 34 SNFs (12 intervention, 22 control) that reported consistently low or moderate INTERACT use had statistically insignificant changes in hospitalizations and ED visit rates. Conclusion: Increased reported use of core INTERACT tools was associated with significantly greater reductions in all‐cause hospitalizations and PAHs in both intervention and control SNFs, suggesting that motivation and incentives to reduce hospitalizations were more important than the training and support provided in the trial in improving outcomes. Further research is needed to better understand the most effective strategies to motivate SNFs to implement and sustain quality improvement programs such as INTERACT. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=131948942
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/jgs.15476
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 1830
    Subjects:
      – SubjectFull: Health care intervention (Social services)
        Type: general
      – SubjectFull: Medical quality control
        Type: general
      – SubjectFull: Critical care medicine
        Type: general
      – SubjectFull: Hospital care
        Type: general
      – SubjectFull: Hospital emergency services
        Type: general
      – SubjectFull: Medical appointments
        Type: general
      – SubjectFull: Motivation (Psychology)
        Type: general
      – SubjectFull: Nursing care facilities
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      – SubjectFull: Self-evaluation
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      – SubjectFull: Surveys
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      – SubjectFull: Secondary analysis
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      – SubjectFull: Human services programs
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      – SubjectFull: Patient readmissions
        Type: general
      – SubjectFull: United States
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      – TitleFull: Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations.
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            – D: 01
              M: 09
              Text: Sep2018
              Type: published
              Y: 2018
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