Dan Osterweil, MD, medical director at SCAN Health Plan, told an
audience of healthcare professionals recently that proven care paths and
a team approach can help reduce the rate of hospital readmissions among
residents of nursing homes and skilled nursing facilities.
"Frontline physicians, administrators and nurses can all work together
to reduce avoidable hospital readmissions," said Dr. Osterweil. "This
takes teamwork, training and systems that are designed to promote early
intervention and timely communication."
Dr. Osterweil made his comments at the 2012 Annual Quality Symposium,
"Road Map to Quality in Skilled Nursing Facilities." The event was
co-sponsored by the California Association of Long Term Care Medicine,
the California Association of Health Facilities and the Health Services
In his presentation Dr. Osterweil emphasized the INTERACT II
(Interventions to Reduce Acute Care Transfers) program that allows
nurses to identify important changes in residents' behavior. INTERACT II
improves early identification, assessment, documentation and
communication about changes in the status of residents in skilled
nursing facilities. In addition, he highlighted the most common
conditions leading to readmissions nd proposed strategies for the
management of these conditions in the nursing home setting.
As a follow-up to the symposium, Dr. Osterweil is working with the event
sponsors in offering coaching assistance in INTERACT II methods to
nursing homes. Approximately 100 teams consisting of nurses, physicians
and administrators are currently participating. The coaching is being
conducted through a series of webinars, with smaller work groups meeting
online monthly with coaches to problem solve and share information about
what is working in their facilities and what needs to be improved.
"Hospitalization can be traumatic for nursing home residents as well as
costly for hospitals, nursing homes and the patients themselves," said
Dr. Osterweil. "Healthcare professionals have a moral obligation to come
together and learn ways to reduce the rate of preventable readmissions
for this vulnerable population."
Dr. Osterweil is immediate past president of the California Association
of Long Term Care Medicine. In addition to providing continuing medical
education credits for those attending the symposium, SCAN has made an
ongoing commitment to preventing hospital readmissions. SCAN adopted the
"Care Transitions" model of care in 2005 to enhance its suite of case
management programs for members at high risk of hospitalization. This
program links nurses and social workers with SCAN members while they are
still in the hospital as well as at specified intervals following
discharge to answer questions and help with medications, explain what to
do if symptoms worsen, and help patients reach personal health goals.
SCAN Health Plan has been focusing on the unique needs of seniors for
more than 35 years. As the nation's third largest not-for-profit MAPD
plan, SCAN currently has nearly 130,000 members in California and
Arizona. Further information may be obtained at scanhealthplan.com
or on Facebook at facebook.com/scanhealthplan.
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