The Impact of Quality Improvement Coaching on Skilled Nursing Facilities to Improve Transitions

2019 ◽  
Vol 20 (3) ◽  
pp. B25-B26
Author(s):  
Mamata Yanamadala ◽  
M. Yanamadala ◽  
H. Jacobson ◽  
A. Mims
2019 ◽  
Vol 54 (6) ◽  
pp. 1184-1192 ◽  
Author(s):  
Rachel M. Werner ◽  
R. Tamara Konetzka ◽  
Mingyu Qi ◽  
Norma B. Coe

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S160-S160 ◽  
Author(s):  
Tamanna Hossin ◽  
Mozhdeh Bahranian ◽  
Lyndsay Taylor ◽  
David Nace ◽  
Christopher Crnich

2018 ◽  
Vol 39 (8) ◽  
pp. 855-862 ◽  
Author(s):  
Mark Toles ◽  
Jennifer Leeman ◽  
Cathleen Colón-Emeric ◽  
Laura C. Hanson

Prior studies have not described strategies for implementing transitional care in skilled nursing facilities (SNFs). As part of the Connect-Home study, we pilot tested the Transition Plan of Care (TPOC) template, an implementation tool that SNF staff used to deliver transitional care. A retrospective chart review was used to describe the impact of the TPOC template on three implementation outcomes: reach to patients, staff adoption of the template, and staff fidelity to the intervention protocol for transition care planning. The template reached 100% of eligible patients ( N = 68). Adoption was high, with documentation by four disciplines in 90.6% of patient records ( N = 61). Fidelity to the intervention protocol was moderately high, with 73% of documentation that was concordant with the protocol. Our findings suggest an electronic medical record (EMR)-based implementation tool may increase the ability of staff to prepare older adults and their caregivers for self-care at home. Further research is needed to test the efficacy of the protocol on patient outcomes after transitions from SNF to home.


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