Pilot Project at Brookdale Assisted Living Communities Reduces Hospital Admissions
BRENTWOOD, Tenn., Feb. 23, 2016 /PRNewswire/ -- With reducing avoidable hospital admissions among older adults important for improving quality of life and cutting healthcare costs, a pilot program shows assisted living can have significant impact on the issue. This finding comes from a three-year initiative involving Brookdale Senior Living and funded by a $7.3 million Centers for Medicare and Medicaid Services Health Innovations Challenge grant. Brookdale, one of the few post-acute care providers to receive an Innovation Grant in the initial funding round, carried out the endeavor in partnership with the University of North Texas Health Science Center and Florida Atlantic University.
To carry out the pilot, Brookdale and the innovation grant team adapted a quality improvement program for use in 46 of Brookdale's assisted living communities and also utilized the tool in 26 of the company's skilled nursing communities. During the pilot, hospital admissions decreased 17% among the assisted living residents and dropped 16% for those in skilled nursing. The total cost of care in skilled nursing also decreased 13%.
The project centered on introducing "Interventions to Reduce Acute Care Transfers," a quality improvement program, into the communities. Known as INTERACT™, the program was developed primarily for use in skilled nursing facilities by a Florida Atlantic University team led by Dr. Joseph Ouslander. INTERACT provides checklist and communication tools to help care teams better determine when an older adult really needs to go to the hospital. To modify it for assisted living, project organizers selected components identified as most relevant for those seniors. Key elements were the STOP and WATCH and SBAR (Situation, Background, Assessment, Recommendations) communication tools, as well as advance care planning resources.
"The program worked because it combines the observation and timely reporting of health changes with the STOP and WATCH tool. The SBAR is a methodical way of communicating with physicians and the advance care planning tools help identify a residents' wishes and goals of care before a crisis arises," said Dr. Kevin O'Neil, Brookdale's chief medical officer and pilot project co-director. "Another crucial component of the study was the development and implementation of a comprehensive care transition management technology platform, because capturing data is now an even more important aspect of healthcare. Measurement is necessary in order to determine if a project results in improvement in care quality."
Training of entire community teams on how to use INTERACT was also crucial, he said. "We educated every associate from bus drivers to wait staff to caregivers because they all work with our residents every day. Our associates often know when something is not right with a resident, so their observations are important. We are not asking them to determine the reason for the change in condition, but we are asking them to report what they are observing, so that a clinical evaluation can be done by a nurse or physician. Timely onsite assessment and intervention can often reduce the need for transfer to the hospital. This is very important to improving health outcomes, reducing avoidable hospitalizations, and reducing the overall cost of care." One example is a senior experiencing confusion, fever and shortness of breath, a condition that commonly occurs among older adults. INTERACT provides step-by-step guidance for communication with a physician. The tools provide guidance on what information the associate should gather (such as vital signs, medication list, allergies) before calling the doctor. With this information, the physician can better determine if the resident can be treated on-site or needs to be transferred to the hospital for further evaluation.
Thomas J. Fairchild, the University of North Texas Health Science Center professor who co-directed the project, said: "It is about changing peoples' habits and that can be a challenging task. The quality and consistency of training are essential to its success."
"The pilot's results demonstrate the important role that assisted living can serve in containing healthcare costs while providing greater quality of life to seniors," Dr. O'Neil said. "Assisted living offers the tremendous benefit of a home-like environment. With the availability of onsite home health and therapy services and appropriately trained staff, assisted living can be a lower-cost care option than skilled nursing," he said. "With the number of residents with more health challenges rising, we can accommodate them in this wonderful setting and keep them from making unnecessary hospital visits by providing comprehensive associate training and the right resources."
Brookdale is currently examining implementing the program into more of its assisted living communities. The INTERACT tools are available to any assisted living provider through the Florida Atlantic University website.
For more information on Brookdale, visit brookdale.com.
About Brookdale
Brookdale Senior Living Inc. is the leading operator of senior living communities throughout the United States. The Company is committed to providing senior living solutions primarily within properties that are designed, purpose-built and operated to provide high quality service, care and living accommodations for residents. Currently Brookdale operates independent living, assisted living, and dementia-care communities and continuing care retirement centers, with approximately 1,123 communities in 47 states and the ability to serve approximately 108,000 residents. Through its ancillary services program, the Company also offers a range of outpatient therapy, home health, personalized living and hospice services.
*INTERACT is a registered trademark of Florida Atlantic University.
Contact: Kristin Puckett, 615-564-8481, [email protected]
Photo - http://photos.prnewswire.com/prnh/20160222/336097
SOURCE Brookdale Senior Living Inc.
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