Nursing Facility Research Partnership Steering Committee Community: Leslie Eber, MD; Joanna Trojanowski, MD; Ruth Cohn Academic: Heidi Wald, MD; Rebecca Boxer MD, Cynthia Drake, MA Contact Rebecca S. Boxer, MD, MS Divisions of Geriatric Medicine and Cardiovascular Medicine University of Colorado School of Medicine Rebecca.Boxer@ucdenver.edu

Why Research in Nursing Homes? To learn how to improve care. To combat the shifts in care which occur from anecdotal events To provide evidence which can inform policies and regulations To find a better way

Partnerships to Change Care UC Researchers Nursing Facility

How are we Partnering Long Term Care Research Partnership – Steering Committee 2 community physicians and 2 researcher physicians Long Term Care Stakeholder Advisory Board Vet research to assure appropriate for nursing facilities Assist researchers in navigating the “nursing home world” Identify key areas of need for research to improve quality of care. Nursing Home Research Consortium Identifying nursing homes which are interested in being research partners throughout the state.

Ongoing Research UTI DECIDE Collaboration with the CDC to provide clinical decision support for nursing homes Produced an App which reflects workflow in nursing homes Usability testing followed by field testing This work is specific for urinary tract infection (UTI) but has methodological implications for other conditions

Cultural Shift in SNF Rehabilitation Paradigms To promote a cultural shift in SNF rehabilitation, we have designed an interdisciplinary “IntenSive Therapeutic Rehabilitation for Older Skilled NursinG HomE Residents” (I-STRONGER) program, which integrates principles of physiologic tissue overload into rehabilitation interventions. We will address previously documented barriers to cultural change in SNFs by appointing clinical advocates to promote I-STRONGER and integrating high-intensity principles into routine rehabilitation interventions to minimize staff time. Low-Physiologic Intensity High-Physiologic Intensity

UPDATE: A Randomized Trial of Heart Failure Disease Management vs UPDATE: A Randomized Trial of Heart Failure Disease Management vs. Usual Care What we will learn from this trial: Does HF disease management improve outcomes while a patient is in the SNF and after they leave? Do patients feel better if HF disease management is specifically addressed?

Patient and Family Engagement Funded by the Patient Centered Outcomes Research Institute Learn what are the best ways to manage patients based on what we already know (comparative effectiveness research) How to best engage patients and caregivers in their care

What is next? Looking for LTC/SNF partners statewide Planning certification indicating University of Colorado Research Site Do you have ideas regarding research – we would are all EARS! Lets partner to change care!

Supported by: University of Colorado, Clinical and Translational Science Insitute NIH/NCATS Colorado CTSA Grant Number UL1 TR001082-04. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views