Feasibility of Registered Nurse Model to Identify Acute Care Preferences

Acute health care interventions for residents of skilled nursing facilities (SNFs) are often unwarranted, unwanted, and/or harmful. A provider-focused model supporting patient centered and appropriate care among SNF patients, Reducing Avoidable Facility Transfers (RAFT), has previously demonstrated reduced emergency department and hospital utilization by emphasizing appropriate use of Provider Orders for Life Sustaining Treatment (POLST) completion and Do Not Hospitalize (DNH) orders. The RAFT model relied heavily on physicians, nurse practitioners and physician’s assistants.