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An evidence-based tool could soon help assisted living residents and home health care clients avoid unnecessary hospital readmissions. Up until now, nursing homes have been the primary users of the tool, which is called INTERACT (Interventions to Reduce Acute Care Transfers). But the University of North Texas Health Science Center (UNTHSC) and Brookdale Senior Living are currently testing whether the tool can be adapted to other care settings. A $7.3 million Health Care Innovations Grant from the Centers for Medicare and Medicaid Services (CMS) is supporting their efforts.“It’s very exciting,” says Dr. Joseph Ouslander, one of INTERACT’s developers. “The main purpose of this whole grant is to refine the INTERACT program so it can be used in assisted living and in home health, so that it can be used across different settings or capabilities.”
Nursing homes use INTERACT to empower all staff members so they will learn to identify, assess and communicate information about residents’ changing clinical conditions. “Someone...may see a resident is losing weight, or not eating well, or coughing more,” says Dr. Jose Pagan, chair of the Department of Health Management and Policy at UNTHSC. “This set of tools allows you to track that, so that information is reported quickly and something is done about it.”A 2011 study, published in the Journal of the American Geriatrics Society, documented INTERACT’s impressive track record. Nursing homes using the tool experienced a 17% reduction in self-reported hospital admissions over the course of 1 year. Researchers projected that a 100-bed nursing home would spend $7,700 to implement the program. That same nursing home could save Medicare about $125,000 a year.
Despite its documented success in nursing homes, INTERACT may not work as well in assisted living and home care. That’s because these settings have a different consumer base and different staffing models, says Ouslander.“You can’t expect a skilled nursing facility to give the same clinical care as in a hospital, and it’s the same for this,” he told Senior Housing News. “You can’t expect an assisted living community to give the same care as in a skilled nursing facility. That’s unreasonable—and it could be unsafe.”The CMS-funded pilot will identify realistic expectations for using INTERACT in assisted living. If results are promising, Ouslander says he will share the model with other providers of post-acute care.