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Home Based Transitional Care: The Tampa VA Patient Centered Solution to Prevent Readmissions of the Frail Elderly

JAMDA
March 1, 2016
Readmission following discharge is a concern for hospitals, payers, and veterans. Programs targeting single diseases for readmission reduction may miss opportunities to address the complex relationships between multiple domains of care.

High Presence Model in Post-Acute Care: Combating Rehospitalizations Through SNF Specific Care Programs

JAMDA
March 1, 2016
In 2013, 10% of Medicare total program outlays went to spending on post-acute care, a large portion of which can be attributed to Skilled Nursing Facilities (SNFs). These expenditures are partially due to high length-of-stays (LoS), an issue many...

Enhanced Care Program for Transitional Care to Home Upon Acute Care or SNF Discharge: A Quality Improvement Study

JAMDA
March 1, 2016
A care transition represents a vulnerable time for older adults, especially those experiencing cognitive or functional impairment, low health care literacy, multiple chronic conditions, or lack of caregiver support. Integrated and home-based...

Encouraging the Appropriate Use of Proton Pump Inhibitors (PPIs) in Long-Term Care Through a Quality Improvement (QI) Project

JAMDA
March 1, 2016
PPI use has increased over the years. Once begun, PPIs tend to be used for long periods without clear therapeutic intent. PPIs are generally safe but long term use is linked to nutritional deficiencies, infections, fractures and more. It is hence...

Decreasing Readmissions Through Transitional Care from Skilled Nursing Facilities to Home

JAMDA
March 1, 2016
Hospitals and skilled nursing facilities (SNF) face growing financial pressure to decrease readmission rates. Transitional care has proven effective for patients with chronic conditions across healthcare settings, typically from the hospital to home...

Curtailing Antipsychotic Use in LTC Medicine: Reducing Off-Label Antipsychotic Medication Use Among Maine Skilled Nursing Centers with the CALM Intervention

JAMDA
March 1, 2016
In 2012, ∼25% of skilled nursing center residents nationwide were prescribed antipsychotics, despite a 2005 Federal Drug Administration “black box” alert warning that these medications may increase residents' risk of heart failure, sudden death, and...

Caring for Patients Outside the Clinic: A Toolkit for Improving Quality and Efficiency

JAMDA
March 1, 2016
Patients receive medical care in a variety of settings including long-term care (LTC) nursing facilities, assisted living facilities, transitional care facilities, and private homes. The number of patients who require skilled nursing care either at...

Antipsychotic and Other Psychotropic Medications in Special Care Dementia Units: Outcomes Using a Mini Behavior Rating Scale and Objective Medication Use Guideline

JAMDA
March 1, 2016
National antipsychotic use in the long-stay residents has declined to 19% now. Efforts are underway to reduce this rate even further. In specialized dementia units, however, where patients with BPSD are concentrated, medication use rates are...

An Innovative State-Level Collaboration to Impact Polypharmacy in Indiana Nursing Homes

JAMDA
March 1, 2016
Reducing polypharmacy is a priority of CMS and AMDA. The Indiana State Department of Health (ISDH) has approved a collaborative proposal that will build an innovative infrastructure of quality improvement (QI) and formally engage nursing home...

Amiodarone Use in Post-Acute and Long-Term Care Residents

JAMDA
March 1, 2016
Amiodarone is a potent antiarrhythmic which is effective for maintaining sinus rhythm but with potentially disabling side effects. There are well known black-box warnings associated with its continued use: sudden death and deadly side effects...