Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations
Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations
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DOI：
10.1111/jgs.15476
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发表时间：
2018-09-01
影响因子：
6.3
通讯作者：
Ouslander, Joseph G.
中科院分区：
文献类型：
--
作者：
Huckfeldt, Peter J.;Kane, Robert L.;Ouslander, Joseph G.
目的设计确定减少急性护理转移干预措施 (INTERACT) 计划的实施程度是否与熟练护理机构 (SNF) 居民的住院次数和急诊科 (ED) 就诊次数相关。来自随机对照试验的二次分析。设置来自美国各地的参与者 SNF (N=264)。随机试验中的 200 个 SNF 提供了有关 INTERACT 使用的基线和干预数据。干预措施测量12 个月期间，干预 SNF 接受了 INTERACT 实施的远程培训和支持；对照 SNF 没有，尽管大多数对照设施在试验之前和试验期间自行使用 INTERACT 计划的各个组成部分。INTERACT 使用数据基于随机分配到干预组的 SNF 的每月自我报告以及对照 SNF 的干预前和干预后调查。主要结果是全因住院率、潜在可避免住院率 (PAH)、未入院的急诊室就诊以及 30 天再入院率。 结果结论报告 INTERACT 使用增加的 65 个 SNF（32 个干预组，33 个对照）的全因住院率减少了（每 1,000 个住院日 0.427 例；与基线相比相对减少 11.2%，p）
ObjectivesDesignTo determine whether degree of implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) program is associated with number of hospitalizations and emergency department (ED) visits of skilled nursing facility (SNF) residents.Secondary analysis from a randomized controlled trial.SettingParticipantsSNFs from across the United States (N=264).Two hundred of the SNFs from the randomized trial that provided baseline and intervention data on INTERACT use.InterventionsMeasurementsDuring a 12-month period, intervention SNFs received remote training and support for INTERACT implementation; control SNFs did not, although most control facilities were using various components of the INTERACT program before and during the trial on their own.INTERACT use data were based on monthly self-reports for SNFs randomized to the intervention group and pre- and postintervention surveys for control SNFs. Primary outcomes were rates of all-cause hospitalizations, potentially avoidable hospitalizations (PAHs), ED visits without admission, and 30-day hospital readmissions.ResultsConclusionThe 65 SNFs (32 intervention, 33 control) that reported increases in INTERACT use had reductions in all-cause hospitalizations (0.427 per 1,000 resident-days; 11.2% relative reduction from baseline, p