Reducing Hospitalizations of Nursing Home Residents
Completed · Not applicable
Conditions studied: Unnecessary Hospitalizations of Nursing Home Residents
In brief
This project directly addresses the national imperative for innovative strategies to improve care for Medicare beneficiaries and reduce health care costs. The overall objective of the proposed project is to improve the care of older individuals who reside in nursing homes (NHs), and at the same time reduce unnecessary Medicare expenditures. This goal will be accomplished by testing a quality improvement program designed to reduce the number of avoidable hospitalizations of NH residents in a randomized controlled trial. The primary hypotheses to be tested are: Hypothesis1: Interventions to Reduce Acute Care Transfers (INTERACT) implementation NHs will have a greater reduction in hospitalization rate than the control and monitoring only NHs during the 12-month implementation compared to a 12-month baseline period. Hypothesis 2: Reductions in Medicare expenditures for hospitalizations in the INTERACT implementation NHs will be greater than the estimated costs of implementing the intervention. Hypothesis 3: The effects of INTERACT on hospitalization rates will be greater among patients on the Medicare skilled benefit for post-acute care, than for long-stay patients. Hypothesis 4: The effects of INTERACT on hospitalization rates will be greatest among those NHs with higher vs. lower intensity (fidelity) of implementing the program. Hypothesis 5: There will be a greater reduction in measures of hospitalizations for conditions defined as "potentially preventable" than for other transfers and hospitalizations. Hypothesis 6: Implementation of INTERACT will not be associated with worsening of relevant quality measures in the participating NHs.
Key facts
- Study ID
- NCT02177058
- Run by
- Florida Atlantic University
- People needed
- 264
- Starts
- 2012-01-01
- Expected to finish
- 2021-02-28
- Last updated by the study team
- 2022-08-04
Who can join
Age: any. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- > 40 Beds
- MD, NP or PA available on-site at least 1/week
- Capable of Starting intravenous fluids
- Capable of Providing respiratory treatments
- Capable of Assessing oxygenation status by pulse oximetry
- < 4 hrs turnaround time for STAT medications ("stat" is an abbreviation of the Latin word statim, meaning "immediately, without delay")
- < 8 hrs. turnaround time for STAT laboratory tests
- < 8 hrs. turnaround time for STAT X-rays
- Computers available for online staff training
- Strong support for participation from the facility administrator, director of nursing, and medical director, as well as corporate leadership (for NHs that are part of a corporate chain), as evidenced by a signed agreement before enrollment
- > 10% 30-day readmission rates
You may not qualify if…
- Hospital based
- Having only private pay residents (no Medicare/Medicaid, no Medicare provider number).
- Participation in a project designed specifically to reduce acute care transfers or hospitalization rates (including federal demonstrations)
- Conducting more than one other major quality improvement or research project during the project period which would threaten their ability to fully participate in the trial.
- Specialize in Pediatrics (> 30 % of patients in NHs are pediatric)
- Specialize in HIV (> 30 % of patients in NHs are HIV)
- Specialize in Respiratory care with ventilator care (>30% of patients in NH are in this category)
- Robust INTERACT implementation and/or very low hospitalization rate
- Located in a country outside USA
Where it is running
- Florida Atlantic University, College of Medicine/College of Nursing — Boca Raton, Florida, United States
Full record on ClinicalTrials.gov
Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.