ArticleJournal of the American Medical Directors Association2019
Reducing Avoidable Facility Transfers (RAFT): Outcomes of a Team Model to Minimize Unwarranted Emergency Care at Skilled Nursing Facilities.
Article in Journal of the American Medical Directors Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Assessment tools addressing avoidable care transitions in older adults: a systematic literature review.European geriatric medicine · 2024Pooled it
- Strategies to Improve Emergency Transitions From Long-Term Care Facilities: A Scoping Review.The Gerontologist · 2024Article
- Evaluating the implementation fidelity to a successful nurse-led model (INTERCARE) which reduced nursing home unplanned hospitalisations.BMC health services research · 2023Article
- Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundAcute health care interventions for residents of skilled nursing facilities (SNFs) are often unwarranted, unwanted, and/or harmful. We describe a provider-focused care model to reduce unwarranted or unwanted acute health care utilization.
objectiveAssess the capability of the Reducing Avoidable Facility Transfers (RAFT) model to reduce unwanted and unwarranted acute health care utilization among residents in 3 rural SNFs between January 1, 2016 and June 30, 2017.
designProspective cohort, pre/post study.
settingThree rural SNFs in collaboration with a geriatric practice in a tertiary academic medical center.
participantsPost-acute care (PAC) and long-term care (LTC) residents of 3 rural SNFs.
interventionRAFT includes the following components: (1) a small team of providers who manage longitudinal care and after hours call; (2) elicitation of advance care plans and preferences regarding acute care; (3) standardized communication process engaging the provider at the identification of an acute care event; (4) a biweekly case review of all emergency department (ED) transfers. MEASURES: ED and hospital utilization.
resultsRAFT demonstrated a 35% reduction in monthly ED transfers and a 30.5% reduction in monthly hospitalizations. These reductions were greatest for LTC residents. CONCLUSIONS/IMPLICATIONS: The RAFT approach substantially reduced unwarranted ED and hospital utilization in this study. Results support replication and evaluation in a larger, more diverse setting and population.
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