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INTERACT Implementation at FHRNC

INTERACT Implementation at FHRNC . Melissa Clark, RN Director of Nursing Fauquier Health Rehabilitation & Nursing Center. www.fhrnc.org. INTERACT Goals. Our goals with INTERACT are… Improve the care of residents.

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INTERACT Implementation at FHRNC

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  1. INTERACT Implementation at FHRNC Melissa Clark, RN Director of Nursing Fauquier Health Rehabilitation & Nursing Center

  2. www.fhrnc.org

  3. INTERACT Goals Our goals with INTERACT are… Improve the care of residents. Reduce the frequency of potentially avoidable transfers to the hospital. Prepare for changes in Medicare reimbursement Increase the confidence level of our nurses. Improved communication among caregivers, residents, and families during care transitions.

  4. Initial Conversations Conversations about readmissions Care transition team with local hospital Opportunity to review Interact tools after tracking readmissions to hospital Avoidable versus unavoidable Partnership with local ED and nursing home capabilities list established

  5. Implementation process (Mar 2011) Used Dehydration Care Pathway when we had GI virus (Jan 2012) SBAR tool reviewed/adopted for communication method (Feb 2012) Initial conversations with nurses about SBAR (Mar 2012) Presentation of INTERACT to Quality Board (May 2012) Utilization of Quality improvement worksheets (Oct 2012) Full implementation of SBAR in clinical record (Nov 2012) Re-education ofnurses on SBAR Stop and Watch education for CNAs and implemented tools within CNA documentation

  6. INTERACT Tools Used • Communication Tools • Stop & Watch , SBAR • Resource manuals placed at nursing stations • Care Paths and Clinical Assessment Tools • Used as reference to guide process for next steps

  7. SBAR Implementation FY 2013 2012 All Cause Readmission Rate -26% 2013 All Cause Readmission Rate - 19%

  8. Expected Next Steps • Readmission Tracking Forms • Stop & Watch and Nursing Home Capabilities education • Facility • Family • Physicians • Advanced Care planning

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