Reducing Unnecessary Hospital Transfers

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Reducing Unnecessary Hospital Transfers

• Ellen Rychlik, RN, BSN
• Elderwood Health Care at Lakewood

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Faculty Disclosures

• Ellen Rychlik, RN, BSN has disclosed that she has
  no relevant financial relationship(s).

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Learning Objectives

• By the end of the session, participants will be
  able to
• Identify the Risks Associated with
  Hospitalization of the Frail Elderly
• Define Impact of Reduction in Unnecessary
  Hospital Transfers on Overall Resident/Family/Staf
  f Satisfaction
• Understand Strategical Elements of Process
  Improvement

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Facility Demographics

• Elderwood Health Care at Lakewood
• Hamburg, New York
• 166 Beds
• Privately Owned

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Reducing Unnecessary Hospitalization

• Risks Associated with Hospitalization
• Increased delirium
• Sleep deprivation
• Immobility
• Dehydration
• Falls
• Malnutrition
• Pressure Ulcers

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Improving Quality of Life

• Decrease interruption of daily care to the
  resident
• Increase treatment options in-house
• Maintain function ability

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Data Collection and Analysis

• Hospitalization Tracking Record
• Transferring Physician
• Admission to Hospital
• Time of Transfer
• Symptomatollogy Necessitating Hospital Transfer
• Admitting Diagnosis

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Hospitalization Tracking Record

• Identification of Case Review Strategical
  Opportunities
• Improved Advanced Care Planning
• Identification of Educational Opportunities for
  Future Staff Development
• Readily Identifies Causes and Trends that Result
  in Residents Being Transferred to the Hospital

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Goals of the LTC Industry

• Maximize Function Ability
• Maintain Skin Integrity
• Minimize Weight Loss
• Prevent Immobility
• Maintain Quality of Life

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Daily Acuity Reporting Tool

• Reviewed daily by the IDT
• Uses the acronym PARED with
• P Identifying the (P)roblem
• A Choosing an appropriate (A)ction
• R Monitoring of residents (R)esponse
• E Evaluating the (E)ffectiveness of the
  action or intervention in treatment
  of the problem
• D (D)iagnosticTesting monitoring of
  
  pertinent lab values, radiology reports,
  ECG,etc.

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Elderwood Health Care at Lakewood Daily Acuity
Reporting Tool
Unit 1 2 3 Team 1 2 3 4
February , 2009
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Outcomes

• Resident Outcomes
  
  Decreased
  Hospitalizations Increased Satisfaction

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Outcomes

• Regulatory Outcomes
  
  DART Elimination of Clinical/Delay in
  Treatment Deficiencies
• Quality of Service
  
  Experts in Gerontology Treating Residents at
  Home

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Outcomes

• Enhanced Staff Performance
  Exciting
  and Rewarding Environment with Coinciding
  Reduction in Turnover
• Effect on Staffs Routine Work
  They are
  Given the Tools they Need to Work More
  Efficiently (Actionable Information)
• Improved Organization Management Structure
  

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Outcomes

• Financial Outcomes
  
  Keeping the Cost Down by Avoiding the Costly
  Risks Associated with Hospitalizations

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Improved Quality of Life for the Resident
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Questions