CALA’s 2016 theme, Aspire, challenges our members and supporters to look forward to the future we are creating for our residents, explore new ways of delivering quality care, and celebrate what has always made us great. Today, we’re bringing you the story of Brookdale Senior Living and INTERACT, collaborators in care quality.
In 2013, we wrote about how health care reforms would impact the provision of care, including an increased emphasis on reducing hospital readmissions. In the same issue of News & Views, we learned about an exciting new pilot project being launched by Brookdale Senior Living in partnership with the University of North Texas Health Science Center and Florida Atlantic University.
The INTERACT (Interventions to Reduce Acute Care Transfers) program aims to improve care quality by focusing on the management of acute changes in residents’ conditions. Originally developed for skilled nursing facilities, the program was expanded by Brookdale’s pilot project to include clinical and educational tools as well as care approaches developed specifically for use in Assisted Living.
Results from the pilot were recently released, and they are promising. According to a press release, “During the pilot, hospital admissions decreased 17% among the assisted living residents.”
The press release continues:
“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.”
The link to the INTERACT tools is provided on CALA’s website for our members and other providers to access. These positive results show that Assisted Living is an important component of the continuum of care.