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AMDA Long Term Care Medicine - 2012


C22 - Slowing the Revolving Door: Project Re-Engineered Discharge (RED) in the Nursing Home Setting


Mar 10, 2012 4:00pm ‐ Mar 10, 2012 5:30pm

Standard: $24.00

Description

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 1.5 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 1.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
Project Re-Engineered Discharge has been shown nationally to reduce hospitalizations by taking information from the electronic medical record and converting it to language geared toward patients and families. In this way, patients and families have increased engagement and understanding of their diagnoses, medications, and follow-up appointments thereby lowering hospital utilization. The experience of implementing this program on a skilled nursing unit will be discussed.

Learning Objectives(s):

  • Discuss the national scope of rehospitalization issues in subacute care.
  • Provide an overview of evidence-based models to reduce hospitalizations with a focus on Project RED.
  • Describe project RED implementation on a skilled nursing unit.


Speakers(s):
Randi Berkowitz, MD, CMD; Claudemay Berger, RN, BSN, CRRN; Robert Schreiber, MD, CMD; Zachary Fang

Disclosure(s):
Randi Berkowitz, MD, CMD has no financial disclosures to report. Claudemay Berger, RN, BSN, CRRN has no financial disclosures to report. Robert Schreiber, MD, CMD has no financial disclosures to report. Zachary Fang has no financial disclosures to report.

References(s):
References 1. Mor V, Intrator O, Feng Z, Grabowski DC. The revolving door of rehospitalization from skilled nursing facilities. Health Aff (Millwood). Jan-Feb;29(1):57-64. 2. Boockvar K, Fishman E, Kyriacou CK, Monias A, Gavi S, Cortes T. Adverse events due to discontinuations in drug use and dose changes in patients transferred between acute and long-term care facilities. Arch Intern Med. Mar 8 2004;164(5):545-550. 3. Ouslander JG, Lamb G, Perloe M, et al. Potentially avoidable hospitalizations of nursing home residents: frequency, causes, and costs: [see editorial comments by Drs. Jean F. Wyman and William R. Hazzard, pp 760-761]. J Am Geriatr Soc. Apr 2010;58(4):627-635. 4. Sharp JW. Expanding the definition of quality of life for prostate cancer. Cancer. Feb 1 1993;71(3 Suppl):1078-1082. 5. Intrator O, Zinn J, Mor V. Nursing home characteristics and potentially preventable hospitalizations of long-stay residents. J Am Geriatr Soc. Oct 2004;52(10):1730-1736. 6. Turner de S, Beddoes L. Using reflective models to enhance learning: experiences of staff and students. Nurse Educ Pract. May 2007;7(3):135-140. 7. Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Schwartz JS. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. Journal of the American Geriatrics Society. May 2004;52(5):675-684. 8. Jack BW, Chetty VK, Anthony D, et al. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. Feb 3 2009;150(3):178-187. 9. Kauh B, Polak T, Hazelett S, Hua K, Allen K. A pilot study: post-acute geriatric rehabilitation versus usual care in skilled nursing facilities. J Am Med Dir Assoc. Sep-Oct 2005;6(5):321-326. 10. Harris R, Wilson-Barnett J, Griffiths P. Effectiveness of nursing-led inpatient care for patients with post-acute health care needs: secondary data analysis from a programme of randomized controlled trials. J Eval Clin Pract. Apr 2007;13(2):198-205. 11. O 'Reilly J, Lowson K, Green J, Young JB, Forster A. Post-acute care for older people in community hospitals--a cost-effectiveness analysis within a multi-centre randomised controlled trial. Age Ageing. Sep 2008;37(5):513-520. 12. Kane RL, Keckhafer G, Flood S, Bershadsky B, Siadaty MS. The effect of Evercare on hospital use. J Am Geriatr Soc. Oct 2003;51(10):1427-1434. 13. Deutschman M. Interventions to nurture excellence in the nursing home culture. J Gerontol Nurs. Aug 2001;27(8):37-43. 14. Boockvar KS, Burack OR. Organizational relationships between nursing homes and hospitals and quality of care during hospital-nursing home patient transfers. Journal of the American Geriatrics Society. Jul 2007;55(7):1078-1084. 15. Todd V, Van Rosendaal G, Duregon K, Verhoef M. Percutaneous endoscopic gastrostomy (PEG): the role and perspective of nurses. J Clin Nurs. Feb 2005;14(2):187-194. 16. Shippee TP. "But I am not moving": residents ' perspectives on transitions within a continuing care retirement community. Gerontologist. Jun 2009;49(3):418-427. 17. Zwarenstein M, Reeves S, Russell A, et al. Structuring communication relationships for interprofessional teamwork (SCRIPT): a cluster randomized controlled trial. Trials. 2007;8:23. 18. Mazur H, Beeston JJ, Yerxa EJ. Clinical interdisciplinary health team care: an educational experiment. J Med Educ. Sep 1979;54(9):703-713. Figure 1. Figure 2.

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