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The Reducing Avoidable Facility Transfers (RAFT) model reduced emergency department transfers and hospitalizations among skilled nursing facility residents by more than a third, according to a study in the August issue of the Journal of the American Medical Directors Association (JAMDA). 

RAFT consists of a small team of providers who manage longitudinal care and after-hours calls. The model involves actively asking nursing home residents about their preferences, especially around end-of-life care, as well as increased engagement of the primary provider during an acute-care event. There was a bi-weekly meeting to review each case. 

Dartmouth researchers examined the RAFT model among residents in three rural SNFs between January 1, 2016 and June 30, 2017.

Average monthly ED transfers and hospitalizations decreased by 35.8% and 30.5% respectively, according to the results. The reductions were the greatest among long-term care residents.

“Like other models, RAFT provides evidence that much of the acute care provided to SNF residents can be provided more safely, more effectively, and more inexpensively than is currently the norm,” the authors concluded.

This study was conducted by researchers at several Dartmouth entities, including the Hitchcock Medical Center (General Internal Medicine), Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy & Clinical Practice, and Dartmouth Centers for Health & Aging. The Mongan Institute—Massachusetts General Hospital also participated.