Training, support for SNF quality improvement program had no effect on hospitalizations: study

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Nursing homes that received support in implementing a quality improvement program showed little change in hospitalization rates and emergency department visits compared to facilities that had no support, new research shows.

Researchers with the University of Minnesota School of Public Health and Florida Atlantic University conducted the study to determine whether providing training and support for nursing homes implementing the Interventions to Reduce Acute Care Transfers, or INTERACT, program could help cut residents' hospital admissions and trips to the emergency department.

The researchers assigned 85 facilities with no prior INTERACT use into two groups: A control group, and an intervention group that received training and implementation support on the program. The intervention also included tools that could help employees identify and evaluate changes in residents' conditions, improve quality and facilitate advance care planning. The research was led by Robert Kane, M.D., who died in march.

The facilities assigned to the intervention group showed “statistically nonsignificant” drops in hospitalization rates, hospitalizations during the first 30 days following nursing home admission, 30-day readmission rates and emergency room visits, the researchers reported in JAMA Internal Medicine on Monday. The intervention group did show a small reduction in potentially avoidable hospitalizations, but that drop did not hold up against statistical corrections, researchers said.

Researchers said the lack of effect from INTERACT training and support found in the study could be attributed to several factors, including the specific nature of the support provided, the quality of the facilities' staff and care and concerns of legal liability when trying to manage sicker residents within a nursing home.