Accreditation The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: The American Medical Directors Association designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AMDCP Credit Designation: This session has been approved for a total of management 1.0 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: This presentation will highlight the high rate of unnecessary hospital readmissions and Emergency Department visits by nursing home residents. Current best practices strategies to reduce both of these unnecessary uses of health care resources will be reviewed. Outcomes of a recent year-long study between those cared for by best practices and usual care will be compared. This study took place in a single skilled nursing facility thereby eliminating most of the factors that influence outcomes in multinursing home studies.
Cite three elements of nursing home "best practices" to reduce emergency department referrals and hospital readmissions.
Review data regarding ED referral rates and hospital readmission rates among nursing home patients.
List important factors associated with preventable hospital readmissions.
Disclosure(s): Kenneth K. Steinweg, MD, CMD has no financial disclosures to report. Tae Joon Lee, MD, CMD has no financial disclosures to report.
References(s): 1) Walker, JD, Teare GF, Hogan DB et al. Identifying potentially avoidable hospital admissions from Canadian long-term care facilities. Med Care 2009; 47:250-254 2) Ouslander JG, Lamb G, Perloe M et al. Potentially Avoidable Hospitalizations of Nursing Home Residents: Frequency, Causes and Costs. JAGS 2010; 58:627-635. 3) Mor, Intrator, Feng V et al. The revolving door of hospitalizations from skilled nursing facilities. Health Affairs, 2010; 29:57-64 4) Boockvar KS, Gruber-Baldini AL, Stuart B. et al. Medicare expenditures for nursing home residents triaged to nursing home or hospital for acute infections. JAGS 2008; 56:1206-1212 5) Boochvar KS, Gruber-Baldini, AL, Burton, L. et al. Outcomes of infection in nursing home residents with and without early transfer. JAGS 2005; 53:590-596 6) Ouslander JG, Lamb G, Tappen R, et al. Interventions to Reduce Hospitalizations from Nursing Homes: Evaluation of the INTERACT II Collaborative Quality Improvement Project. JAGS 2011; 59:745-753