Interact Tools Implemented to Improve Quality of Care and Reduce Hospitalization

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The quality of care for a resident in a skilled nursing facility can be dramatically enhanced when staff, caregivers and family members are aware of warning signs related to changing health conditions. As part of the Quality Improvement Initiative, Care Compass Network (CCN) is leading a team focused on implementing the regular use of INTERACT (Interventions to Reduce Acute Care Transfers) Tools in skilled nursing facilities within the 9-county region.

The Department of Health approved the INTERACT Project due in part to its Nationally recognized best practices. One of which is to take vitals for residents even when an acute health issue is not apparent. The consistent monitoring will help alert caregivers should a change in vitals suddenly present itself. Similarly, non-clinical staff such as food service employees are encouraged to notify someone if they notice a change in a resident’s appetite or eating habits. Someone from housekeeping might observe a change in mood that doesn’t seem quite right. Even family members can help. Something as simple as mild sweating, sudden fatigue or the presence of a new cough can be reported to nursing staff so that they can  always be aware and watching for indications that a resident might need more frequent follow-up.

Care Compass Network has made training available for partner organizations. Putting the INTERACT tools and best practices into place is hoped to significantly help reduce hospital transfers from skilled nursing facilities.

At UHS Senior Living at Ideal, both the Director of Nursing as well as the Nurse Educator attended training to become Champion and Co-Champion for their organization. CCN reimbursed Ideal for the Champion training and made it possible for additional nursing leaders to participate as well. A Family Council meeting takes place at Ideal every other month and this past winter, the nursing educator, administrators and social worker took the opportunity to educate family members about the “Stop-and-Watch” tool. 20 family members were in attendance and learned how to be an active participant in the INTERACT process.

Now that the Stop-and-Watch program has been in place for several months, the system is hard wired. It’s helped families feel even more confident about their loved one’s care and has resulted in an even stronger collaboration in nursing to physician communications. Another tool that has helped strengthen communication is the SBAR communication form. The form requires information on Situation, Background, Appearance and Review and notify. This standard method of evaluation helps the nursing team prepare all the necessary information critical for the physician before picking up the phone. The process helps the RN make a confident assessment and insures a clear and thorough transfer of information to the physician.

The Ideal team is pleased with the response they have had from families since sharing information about the INTERACT tools. This summer they will hold a six-month check-in meeting with the Family Council to see how the new tools are working from their perspective.