By: Dr. Tom Sequist
This is the fourth in an ongoing series by our Quality, Safety & Value team highlighting Partners HealthCare’s efforts to develop and implement best practices across our network of hospitals to improve the quality of care patients receive while reducing costs.
When our patients need care after a hospital stay, it can be challenging to figure out which rehabilitation facility best meets their needs. That’s why Partners HealthCare has been exploring new ways to help our patients, their families and care providers better navigate their options.
Skilled nursing facilities or SNFs (sometimes called “nursing homes”) provide a high level of care for many patients discharged from the hospital. Physicians supervise the medical care in SNFs, and nurses and other health care professionals help patients as they recover. Until recently, there were no widely available data on quality, safety, or cost for individual SNFs. This forced nurses, case managers and doctors at the hospital to rely on anecdotes when recommending which SNF might be the best fit for a patient. Recently, though, there has been progress in making quality data on SNFs publicly available. Using these data and additional non-public information, Partners has created a robust, transparent process to build a network of high-quality SNFs to serve our patients – the Partners SNF Collaborative Network.
The Selection Process
Now entering its third year, the Partners SNF Collaborative Network includes 60 skilled nursing facilities out of 152 who initially applied for membership. These 60 SNFs underwent a rigorous evaluation to ensure they provided good patient care.
Applicants interested in joining the Network have to meet two initial criteria. First, they have to meet a minimum standard of at least three out of five stars on Medicare’s Nursing Home Compare rating. Second, they have to meet the Massachusetts’ state average score on the department of public health’s annual licensure survey. SNFs that meet those criteria are invited by Partners to be evaluated further and scored based on tenure of senior staff, average length of patient stay, certification(s) of the medical director, use of electronic health records, insurance plans accepted, and geographies served.
Those not selected are invited to meet with us to discuss their results in order to understand how to improve their chances of being invited to join the Collaborative Network in the future. Some SNFs that were not invited to participate have since put improvement programs in place and reapplied the following year.
A Better Network for Better Outcomes
Patients who go to a Network SNF rather than a non-Network SNF have been able to go home sooner and are less likely to be re-admitted to a hospital from the SNF. Patients in Collaborative SNFs experience 14 percent-shorter lengths of stay than those in non-Network SNFs. That means going home more than 2 days earlier during a typical 20-day stay in a SNF.
Patients treated at a Partners SNF Collaborative Network site also have 20 percent-lower readmission rates to their original hospital than patients at non-Network facilities. Beyond the numbers, patients feel confident in their recovery as they know that the facility they are going to is highly rated.
Having seen this unparalleled progress toward improving SNF care, we are intent on creating opportunities to foster further improvements. One way the Network is doing that is by holding bi-annual Learning Collaborative meetings. These meetings are attended by therapists, case managers, doctors, nurses and administrators from Network facilities, as well as from all Partners acute hospitals and Spaulding rehabilitation facilities. The meetings allow for sharing of best practices in areas such as setting patient and family expectations when a patient is transferred from a hospital to a SNF.
As we continue to develop the Network, we’re also working with SNFs to best match the clinical capabilities of each facility with the clinical needs of patients to make sure that patients receive high-quality care throughout the care continuum. We strongly believe that sharing data and maintaining open communication between SNFs and Partners’ hospitals, home care, and long term care providers, improves the quality of care for all patients of post-acute care SNFs.