The National Imperative to Improve Nursing Home Quality Honoring Our Commitment to Residents, Families, and Staff (2022) / Chapter Skim
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Appendix B: Examples from the Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents
Appendix B: Examples from the Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents
Pages 555-560
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Table B-2 shows the impact of the interventions on clinical outcomes and cost savings in phase one. The assessment focused on the following measures: all-cause hospitalizations, potentially avoidable hospitalizations, all-cause emergency department (ED)
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From page 556... ...
program • Reduce hospitalizations • Using feedback forms of the clinical outcome • Reduce Medicare expenditures measures to facilities monthly • Increase use of advance directives and end-of- • Encouraging physician engagement life planning • Using advance directives • Improve early illness recognition • Supporting homes to implement and sustain HIT • Improve management of health conditions • Engaging a multidisciplinary support team • Increase the use of health information technology (HIT) • Reduce medication use (including antipsychotic medications among people with dementia)
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From page 557... ...
• An electronic data tracking system for patient OVERALL GOALS: records and employing RNs • Reduce unnecessary hospitalization • Using APRNs to facilitate standardized education • Improve medical care on quality improvement • Enhance transitional care • Support palliative care Leaders of OPTIMISTIC subsequently helped establish the startup company Probari to implement a program modeled after OPTIMISTIC. Reduce Avoidable Hospitalizations In 2012, the University of Pittsburgh Medical The five interventions were Using Evidence-Based Interventions Center began RAVEN by implementing five • Facility-based enhanced care staff for Nursing Facilities (RAVEN)
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TABLE B-3 Phase Two: Outcomes for Different Intervention Groups Phase Two: Payment plus Clinical Supports Group Phase Two: Payment Only Group MOQI Potentially avoidable emergency department visits and Mixed results, no significant changes across all measures potentially avoidable all-cause transfers significantly increased for the six qualifying diagnoses NY-RAH Mixed direction results for use and expenditure measures, No significant changes in use and expenditure measures none statistically significant OPTIMISTIC Increases in most measures for hospitalization use and Mixed direction for significant changes in expenditures but no expenditures, a few were statistically significant significant changes in use measures RAVEN Significant increases in hospital use and expenditure measures No significant changes across all SOURCE: RTI International, 2021.
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From page 559... ...
2021. Evaluation of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents -- Payment reform: Fourth annual report.
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