Detecting illness early among nursing home residents not only improves patient health outcomes, but also reduces avoidable hospitalizations and saves the facilities money, according to a new study at the University of Missouri.
Marilyn Rantz, a Curator's professor emerita at the MU Sinclair School of Nursing, analyzed six years of financial data for 11 Missouri nursing homes that are part of the Missouri Quality Improvement Initiative, a program that implemented advanced practice registered nurses (APRNs) full time into nursing homes throughout the greater St. Louis area. By reducing avoidable hospitalizations, the nursing homes recaptured more than $32 million in revenue, which helped them retain their staff and allow the residents to remain in the nursing homes while receiving treatment.
"Early illness recognition is key to identifying clinical problems before they become much worse, and the advanced practice registered nurses played a big role in helping the staff make the proper assessments," Rantz said. "Whether it's pneumonia, the flu or a urinary tract infection, If the care providers are letting patients' health decline to the point where you have no choice but to transfer them to the hospital, you let the problem go way too long."
Rantz explained that nearly all clinical signs of an unstable condition can benefit from hydration, and treating patients within the nursing home helps avoid the stress and confusion that often results when older adults are transported to the hospital.
"Keeping the residents moving every day and ensuring they are drinking enough fluids and eating nutritious foods are simple, yet often overlooked strategies that really make a difference," Rantz said. "The residents are much more comfortable being cared for in the nursing home where they are familiar with the staff, and our research shows reducing avoidable hospitalizations saves nursing homes millions in the long run."
In addition to improving the quality of care in nursing homes, Rantz found the implementation of advanced practice registered nurses, who either have a doctoral or master's degree in nursing, can help improve staff skills in care delivery and reduce staff turnover, which has been an ongoing issue for nursing home administrators, particularly during the COVID-19 pandemic.
Marilyn Rantz is a Curators' professor emerita at the University of Missouri's Sinclair School of Nursing.
"We found the more support you give the nursing staff, the greater the impact on reducing staff burnout and turnover," Rantz said. "Staffing is the number one cost for nursing homes, and we found the recaptured revenue from reducing avoidable hospitalizations helps pay and retain staff who are well educated and skilled at their job."
Rantz has dedicated her career to improving the quality of care older adults receive in nursing homes, and last year she saw firsthand the functional decline that can result from illness when an older family member was hospitalized with COVID-19.
"Today, she is still not as functionally strong and active as she was nine months ago when she was originally diagnosed," Rantz said. "It has been a long haul, but she is fortunate, as some older adults never regain their full function after a hospitalization. I am grateful for the opportunity to help those in need and I have dedicated my life to improving the quality of care in nursing homes."
"Financial and workflow benefits of reducing avoidable hospitalizations of nursing home residents" was recently published in the Journal of Nutrition, Health and Aging.
