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Registry of Innovation The New York State Department of Health is a member of the Registry of Innovations, a national registry that seeks to identify and showcase promising practices that have been developed to improve health care delivery in New York.

New Care Model for Nursing Home Residents

The construction industry has a reputation for rapidly adopting new technologies, but one sector has stubbornly resisted change: nursing homes. On any given day, there are more than 1.5 million Americans living in over 15,000 nursing homes across the country. The top complaint by families is that nursing homes provide poor care; residents end up hospitalized at high rates and suffer far more often than their counterparts living in other settings.

New York State’s Department of Health launched the an initiative to address these issues and provide a new model for care in nursing homes. It was piloted in two New York State counties.

The program focuses on identifying residents with the most serious problems, such as those who need help walking or those with urinary tract infections. A small number of high-risk residents are identified as the initiative’s focus population, and teams then work together to provide them better care. Team members may include nurses, physical therapists, social workers, dietary aides, and janitorial staff.

One element of this care is the introduction of new technology: remote patient monitoring. The system, called uKnowMed, uses barcode scanning to automatically track the medications residents are receiving. It provides automated alerts to staff members when it’s time for a resident to receive their next dose of medication. The goal is that this will reduce unnecessary hospitalizations due to missed doses or dangerous drug interactions.

This care also makes use of electronic health records, which includes the uKnowMed system, but also additional information about residents. This technology helps staff members to identify the most vulnerable residents and track their progress over time. It also encourages facilities to organize care based on each resident’s unique needs rather than simple routines that might not always match their current situation. This is designed to promote greater collaboration across disciplines and give residents more active participation in their care.

The program also provides staff members with ongoing education about the strengths, needs, and preferences of each resident. This includes training that helps them improve communication skills, which may help reduce caregiver burnout while improving the quality of life for residents.

Results of the initiative showed that residents’ falls declined 40% (and 16% in control facilities). Hospitalizations due to medication complications dropped by 12%. There was no change in rates of pressure ulcers, which had been a high priority for nursing homes prior to using this care.

Although it is still too early to know whether this model can meaningfully reduce long-term care costs across the board, it does appear to focus on improving resident health rather than simple cost containment.

This is one of 50 initiatives that are profiled in the Department of Health’s Shaping an Innovative Future report (PDF). The Registry of Innovation website also has more information about this and other initiatives.