PMID- 30094818
OWN - NLM
STAT- MEDLINE
DCOM- 20190912
LR  - 20190912
IS  - 1532-5415 (Electronic)
IS  - 0002-8614 (Print)
IS  - 0002-8614 (Linking)
VI  - 66
IP  - 9
DP  - 2018 Sep
TI  - Degree of Implementation of the Interventions to Reduce Acute Care Transfers 
      (INTERACT) Quality Improvement Program Associated with Number of 
      Hospitalizations.
PG  - 1830-1837
LID - 10.1111/jgs.15476 [doi]
AB  - OBJECTIVES: To determine whether degree of implementation of the Interventions to 
      Reduce Acute Care Transfers (INTERACT) program is associated with number of 
      hospitalizations and emergency department (ED) visits of skilled nursing facility 
      (SNF) residents. DESIGN: Secondary analysis from a randomized controlled trial. 
      SETTING: SNFs from across the United States (N=264). PARTICIPANTS: Two hundred of 
      the SNFs from the randomized trial that provided baseline and intervention data 
      on INTERACT use. INTERVENTIONS: During a 12-month period, intervention SNFs 
      received remote training and support for INTERACT implementation; control SNFs 
      did not, although most control facilities were using various components of the 
      INTERACT program before and during the trial on their own. MEASUREMENTS: INTERACT 
      use data were based on monthly self-reports for SNFs randomized to the 
      intervention group and pre- and postintervention surveys for control SNFs. 
      Primary outcomes were rates of all-cause hospitalizations, potentially avoidable 
      hospitalizations (PAHs), ED visits without admission, and 30-day hospital 
      readmissions. RESULTS: The 65 SNFs (32 intervention, 33 control) that reported 
      increases in INTERACT use had reductions in all-cause hospitalizations (0.427 per 
      1,000 resident-days; 11.2% relative reduction from baseline, p<.001) and PAHs 
      (0.221 per 1,000 resident-days; 18.9% relative reduction, p<.001). The 34 SNFs 
      (12 intervention, 22 control) that reported consistently low or moderate INTERACT 
      use had statistically insignificant changes in hospitalizations and ED visit 
      rates. CONCLUSION: Increased reported use of core INTERACT tools was associated 
      with significantly greater reductions in all-cause hospitalizations and PAHs in 
      both intervention and control SNFs, suggesting that motivation and incentives to 
      reduce hospitalizations were more important than the training and support 
      provided in the trial in improving outcomes. Further research is needed to better 
      understand the most effective strategies to motivate SNFs to implement and 
      sustain quality improvement programs such as INTERACT.
CI  - (c) 2018, Copyright the Authors Journal compilation (c) 2018, The American Geriatrics 
      Society.
FAU - Huckfeldt, Peter J
AU  - Huckfeldt PJ
AD  - School of Public Health, University of Minnesota, Minneapolis, Minnesota.
FAU - Kane, Robert L
AU  - Kane RL
AD  - School of Public Health, University of Minnesota, Minneapolis, Minnesota.
FAU - Yang, Zhiyou
AU  - Yang Z
AD  - School of Public Health, University of Minnesota, Minneapolis, Minnesota.
FAU - Engstrom, Gabriella
AU  - Engstrom G
AD  - Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, 
      Florida.
FAU - Tappen, Ruth
AU  - Tappen R
AD  - Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, 
      Florida.
FAU - Rojido, Carolina
AU  - Rojido C
AD  - Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, 
      Florida.
FAU - Newman, David
AU  - Newman D
AD  - Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, 
      Florida.
FAU - Reyes, Bernardo
AU  - Reyes B
AD  - Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, 
      Florida.
FAU - Ouslander, Joseph G
AU  - Ouslander JG
AD  - Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, 
      Florida.
AD  - Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, 
      Florida.
LA  - eng
GR  - NH/NIH HHS/United States
GR  - R01 NR012936/NR/NINR NIH HHS/United States
GR  - 1R01NR012936/National Institute for Nursing Research/International
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20180810
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Health Plan Implementation/*statistics & numerical data
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Medicare
MH  - Patient Transfer/*statistics & numerical data
MH  - Program Evaluation
MH  - Quality Improvement/*statistics & numerical data
MH  - Skilled Nursing Facilities/*statistics & numerical data
MH  - United States
PMC - PMC6156928
MID - NIHMS974551
OTO - NOTNLM
OT  - potentially avoidable hospitalizations
OT  - skilled nursing facilities
COIS- Conflicts of Interest Work on funded INTERACT research is subject to the terms of 
      Conflict of Interest Management plans developed and approved by the FAU Financial 
      Conflict of Interest Committee. None of the other authors have any conflicts of 
      interests.
EDAT- 2018/08/11 06:00
MHDA- 2019/09/13 06:00
PMCR- 2019/09/01
CRDT- 2018/08/11 06:00
PHST- 2017/11/13 00:00 [received]
PHST- 2018/03/29 00:00 [revised]
PHST- 2018/05/07 00:00 [accepted]
PHST- 2018/08/11 06:00 [pubmed]
PHST- 2019/09/13 06:00 [medline]
PHST- 2018/08/11 06:00 [entrez]
PHST- 2019/09/01 00:00 [pmc-release]
AID - 10.1111/jgs.15476 [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 2018 Sep;66(9):1830-1837. doi: 10.1111/jgs.15476. Epub 2018 Aug 
      10.