Documenting Patient Changes as a Team With the INTERACT Program

By Kindred Healthcare
 Dr. Joseph Ouslander

Dr. Joseph G. Ouslander

Professor and Senior Associate Dean for Geriatric Programs at Florida Atlantic University’s College of Medicine

A photo of several elderly women under hair dryers in a beauty salon flashed on the screen, followed by a photo of another elderly woman in a hospital bed.

“If you don’t manage the conditions of elderly people, they’ll end up like this", said Ouslander of the hospital photo.

Believing that “geriatrics is a team sport,” he helped develop the INTERACT program (Interventions to Reduce Acute Care Transfers).

INTERACT helps chart changes that home health aides, CNAs, dietary workers and family members have noticed in patients. The documentation can help:

  • Prevent conditions such as dehydration from becoming severe enough to require hospitalization
  • Manage some conditions in the nursing home without transfer when it’s feasible and safe
  • Improve advance care or palliative care planning when appropriate.

Now in the works is Interact III, which should be available in 2013, Ouslander said. It’s an acute care transfer log based on Excel, and it “had to pass Dr. Joe’s test,” Ouslander said. “I don’t use Excel and I could fill it out.” It calculates a home’s quality monitoring figures and automates the process so the information is no longer on reams of paper.

The program is Florida Atlantic University's initiative to bring the quality improvements of the INTERACT program to Electronic Health Record (EHR) software platforms through an industry-standard certification program. Preliminary information is online now.

Describing their experiences with INTERACT were Rebecca L. Hubbard, Director of Nursing at Kindred Transitional and Rehabilitation Center – Eagle Creek in Indianapolis, and Nancy DeLaurentis, Director of Nursing at Kindred Transitional Care & Rehabilitation-Village Square in San Marcos, Calif.

Hubbard said Eagle Creek mounts Stop and Watch observation forms in hallways -- on hard-to-miss yellow paper -- where they are handy for CNAs and other staff to notice and use. Family members, who often know patients the best, are also encouraged to use the forms.

Dr. Joseph Ouslander