Man with oxygen tube lying in hospital bed

A tool in development called the Avoidable Transfer Scale enables nursing homes to outsource quality improvement work related to potentially avoidable hospitalizations, researchers at the Regenstrief Institute and Indiana University School of Medicine say.

The tool’s development is part of the OPTIMISTIC project, a Centers for Medicare & Medicaid Services demonstration to reduce avoidable hospital transfers of nursing home residents.

The scale uses data commonly included in residents’ electronic health records to identify and characterize potentially avoidable hospitalizations. It also highlights issues that can be handled in the nursing home itself. It has been pilot-tested and is accessible to nursing home stakeholders who wish to check it out while the design continues to be tweaked, study author Jennifer Carnahan, M.D., MPH, M.A., told McKnight’s Clinical Daily.

The research team is now actively working on finding a way to test the tool in other nursing home settings, Carnahan said.

Transfers are a quality measure

Between one quarter and half of nursing home residents’ transfers to hospitals are potentially avoidable, the researchers noted. Transfers serve as both measures of quality in medical care and as important targets for process change by nursing homes, they said.

“The 12-item Avoidable Transfer Scale provides an efficient approach to identify and characterize potentially avoidable hospitalizations using available data from the electronic medical records,” they wrote in the published pilot study. “Increased ability to quantitatively assess the avoidability of resident transfers can aid nursing homes in quality improvement initiatives to treat more acute changes in a resident’s condition in place.”

Future versions of the Avoidable Transfer Scale may also help stakeholders with remote quality improvement initiatives via the EMR, they said. The researchers also foresee possible development of an automated version.

Full findings and a link to the scale were published in the journal Innovation in Aging.

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