Improving Hospital Stays with Community Wide Programs

This study described a series of programs implemented in Syracuse, New York to support the movement of long term acute care patients to skilled nursing facilities. The Difficult to Place Program involved the identification of these patients and the communication of information concerning them between hospitals and nursing homes on a continuing basis. These patients involved approximately 20 percent of new admissions to nursing homes. The Subacute Programs included services such as intravenous therapy and offsite transportation that were not originally available in area nursing homes. The Subacute Program stimulated the development of these services in long term care. The Complex Care Programs have included services for patients with high severity of illness such as multiple intravenous antibiotic therapy and high cost medications. The Subacute and Complex Care Programs included 5 - 6 percent of Difficult to Place patients. The study demonstrated that these programs reduced the number of annual adult medicine and adult surgery patient days by 2288 between 2011 and 2017.