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Nursing Homes Use Tool to Reduce Avoidable Hospitalizations

Communication is a key component in the INTERACT Tools (Interventions to Reduce Acute Care Transfers) that have been successful in reducing avoidable readmissions in Georgia nursing homes. A study of 20 Georgia nursing homes found that, of 200 hospitalizations, 134 (67%) were rated as potentially avoidable by long-term care health professionals. These findings led to the development of the INTERACT Tools to address communication, conditions commonly causing hospitalizations, and advanced care planning.

A second study found that implementation of the tools in three Georgia nursing homes with high baseline hospitalization rates was associated with a 50 percent reduction in the overall rate of hospitalizations and a 36 percent reduction in the rate of hospitalizations assessed as potentially avoidable. Due to the success of the tools, a revised version called INTERACT II is currently being rolled out in 30 nursing homes in New York, Massachusetts, and Florida.

One of the key INTERACT communication tools is SBAR (Situation-Background-Assessment-Recommendation), which has been broadly used in other healthcare settings to provide a standardized approach to information sharing that includes:

    S-Situation: What is happening at the present time?
    B-Background: What are the circumstances leading up to this situation?
    A-Assessment: What do I think the problem is?
    R-Recommendation: What should we do to correct the problem?

Because clinical teamwork often involves hurried interactions between healthcare team members (e.g., CNAs, nurses, physicians) with varying styles of communication, a standardized approach to information sharing ensures that patient information is consistently and accurately exchanged. This is especially true during nurse-physician communication that has the potential to result in unnecessary hospital transfers.

As many nursing homes are caring for sicker residents, building a foundation for improved communication presents an opportunity for nursing homes to effectively manage the care of their residents while avoiding preventable hospitalization that are associated with additional risks.