Analysis explores the secret sauce for successful hospital-SNF collaboration

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Hospitals are working much more closely with skilled nursing facilities, aiming to form bonds and avoid costly and harmful hospital readmissions. But little is understood about how they're creating these linkages.

Aiming to close that knowledge gap, researchers with the Brown University Center for Gerontology and Healthcare Research interviewed staff at 25 SNFs and 16 hospitals to better understand the secret sauce to successful collaboration between the two provider types. They also analyzed data from more than 290,000 patients, discharged from those hospitals between 2008 and 2015.

Although hospital-SNF collaboration requires a big administrative and clinical time investment, it can spell a big positive in patient outcomes.

“We determined that, as you might imagine, when hospitals and SNFs are collaborating, they are sending their patient to higher-quality SNFs, and experiencing reductions in readmissions back to the hospital,” Emily Gadbois, Ph.D., an investigator with Brown University, told McKnight's.

For nursing home leaders, she added, “The takeaway message is — although collaboration takes time, effort and money — it will result in better outcomes and specific ideas of ways to collaborate include focusing on improving communication around the hospital-SNF transition, sharing of staff wherever possible, specific efforts to reduce readmissions, and just getting engaged with the hospital however possible.”

In attempting to categorize types of collaboration, Brown researchers sorted them into three buckets:

  1. Efforts to establish SNF partners: Some hospitals sought to have strong relationships with skilled nursing facilities to which they discharged patients, according to the study.
  2. Initiatives to improve transitions to SNFs: Some hospitals made significant efforts to improve transitions to skilled care facilities. One hospital director interviewed described the systems as going beyond simply focusing on transitions to include the sharing of employees, and development of official relationships.
  3. Hospital staff at the SNF: Other hospitals went as far as placing staff members within nursing homes, in an effort to further collaborate.
Analyzing patient data, they also found that hospitals that had a higher collaboration rate with skilled care saw lower readmission rates from those SNFs at about 10%. That's compared to “low-collaboration” hospitals, which reported a 14% readmission rate. Researchers noted that high collaboration hospitals typically had a greater availability of post-acute providers from which to choose, along with higher quality of nearby SNFs, measured in terms of their star rating. Low collaboration hospitals, meanwhile, served poorer and minority beneficiaries, and were located in markets with less availability of post-acute providers.

The study, published this week in Health Services Research, was funded by the National Institute on Aging and the Commonwealth Fund.