Caring Together: INTERACT NY. January 19, 2012
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2 Caring Together: INTERACT NY January 19, 2012
3 Agenda Introduction to INTERACT Tools and Resources Overview of the INTERACT NY Implementation CNR and NYM Experience with INTERACT Lessons Learned from the Multi-provider Experience Conclusion and Additional Resources
4 INTERACT Tools and Resources Communication Tools Care Paths Advance Care Planning Tools
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8 Quality Improvement Tool Value of tracking residents at risk for transfers who stay in addition to those who go out to the hospital INTERACT tools often assisted in keeping residents in nursing homes - Facilitation of advance care planning discussion - Better communication among the care team and between partners - Identification of opportunities to prevent unnecessary transfers INTERACT tools facilitated certain transfers
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11 CCITI NY Transfer Form
12 Timeline Executive Briefing: Oct SBAR & Stop and Watch Tool: Feb Standardized Transfer Form: Apr Support Tools: Care Paths, Change in Condition File Cards: Jun Advance Care Planning- Cases From the Field: Aug Lessons Learned & Next Steps: Oct Initial Learning Sessions: Oct 2010 & Jan 2011 QI Review Tool & Avoidability: Mar Care Transitions- Partnering With Acute Care Hospitals: May Sharpening Clinical Skills: Jul Engagement of the Frontline Staff: Sep
13 INTERACT NY Design & Opportunities Acute care hospital involvement Cross-setting programs Interdisciplinary staff involvement Frontline staff Clinical staff Emphasis on skill-building of staff Teaching methods: Simulation & Debrief Integration with quality improvement Electronic transfer assessment
14 The Participants Amsterdam Nursing Home Jewish Home Lifecare-Bronx Sarah Neuman Center Beth Abraham Health Services Buena Vida Continuing Care and Rehabilitation Center Center for Nursing and Rehabilitation Dr. Susan Smith McKinney Nursing and Rehabilitation Center Eger Health Care & Rehabilitation Center Elizabeth Seton Pediatric Center Good Samaritan Nursing Home Hebrew Home at Riverdale Helen and Michael Schaffer Extended Care Center Jewish Home Lifecare-Manhattan Lutheran Augustana Center Margaret Tietz Nursing and Rehabilitation Menorah Center Morningside House Orzac Center for Extended Care and Rehabilitation Our Lady of Consolation Parker Jewish Institute Rivington House Ruby Weston Manor Schnurmacher Center for Rehabilitation and Nursing Sea View Hospital Rehabilitation Center and Home St. Catherine of Sienna Nursing Home St. Mary's Hospital for Children Stern Center for Extended Care and Rehabilitation Village Center for Rehabilitation and Nursing Isabella Geriatric Center Rutland Nursing Home
15 Partner Participants Bronx Lebanon Hospital MediSys Health Network Sound Shore Medical Center Brookdale University Hospital Montefiore Medical Center Staten Island University Hospital Catholic Health Services of Long Island Mount Sinai Medical Center Stony Brook University Medical Center Continuum Health Partners, Inc Mount Sinai Queens SUNY Downstate Medical Center Flushing Hospital Nassau University Medical Center Trinitas Regional Medical Center Forest Hills Hospital New York City Health and Hospitals Corporation Wyckoff Heights Medical Center Greenwich Hospital New York Downtown Hospital Jacobi Medical Center New York Presbyterian Hospital Jamaica Hospital Kingsbrook Jewish Medical Center New York University Langone Medical Center Lutheran Medical Center North Shore-Long Island Jewish System Maimonides Medical Center St. Luke s Roosevelt Hospital
16 Train-the-Trainer
17 Member Participation 156 interdisciplinary staff from participant organizations attended learning sessions Additional staff trained at the local level
18 Implementation of Evidence-based Tools % Tools Use Stop and Watch 83% SBAR 75% QI Tool for Review of ACTs 67% Acute Care Transfer Log 50% Care Paths 35% Resident Transfer Form 25% Transfer Envelope and Checklist 25% Change in Condition File Cards 8% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Stop and Watch SBAR Acute Care Transfer Log QI Tool for Review of ACTs Care Paths Use of Tools Resident Transfer Form Change in Condition File Cards Transfer Envelope and Checklist Advance Care Planning Tools Percentage Use Advance Care Planning Tools 8%
19 Recognizing the Value of the Interdisciplinary Team Exemplary Frontline Staff--- N. Moreira, RN Sea View Hospital Rehabilitation Center and Home C. Taylor, CNA Isabella Geriatric Center V. Black, CNA Jewish Home Lifecare- Manhattan L. Davis, LPN Jewish Home Lifecare- Manhattan K. Marte, CNA Isabella Geriatric Center B. Miller, CNA Center for Nursing and Rehabilitation L. Torres, PCT Sea View Hospital Rehabilitation Center and Home
20 Support for Skill-Building
21 Integration of INTERACT into Health Information Technology
22 CNR and NYM Experience With INTERACT NY
23 Lessons Learned Value of tracking residents at risk for transfers who stay in addition to those who go out to the hospital INTERACT tools often assisted in keeping residents in nursing homes - Facilitation of advance care planning discussion - Better communication among the care team and between partners - Identification of opportunities to prevent unnecessary transfers
24 Lessons Learned Continued INTERACT tools helped facilitate certain unavoidable transfers through early identification, communication, and assessment of significant change in a resident s status. Effective implementation of INTERACT is critical to long-term sustainability of the program. The program cannot be effectively implemented or sustained without strong support from facility leadership.
25 Implementation Most organizations implemented in pilot units; Few organizations implemented facility-wide. Many organizations took a staggered approach to implementing tools. At least one organization implemented all tools at the same time. Organizations typically did not implement all tools. Stop and Watch, QI Tool & SBAR are the most commonly adopted tools.
26 Project Results Mean per 1000 Resident-Days Pre-INTERACT NY Post-INTERACT NY Hospital Admissions Pre-INTERACT NY Post-INTERACT NY Hospital Admissions
27 Internet Resources INTERACT Web site: Journal of American Geriatric Society Article: New England Journal of Medicine Article:
28 Questions Roxanne Tena-Nelson Executive Vice President (212) Kathryn Santos Manager of Quality Improvement Initiatives (212)
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