1. Lutheran Senior Services Why we choose Interact II Tools

2. 2 Where we started… Data poor Health Care Reform Growth of short stay rehab program Move to Evidence Based Practice

3. 3 Tools We Are Using Resident Transfer Form Change in condition cards Care Maps SBAR

4. 4 TRANSFERENVELOPETRANSFERENVELOPE

5. 5 Change in Condition Cards

6. 6 CAREMAPSCAREMAPS

7. 7 Define a Process Clinical Guidelines for Management of LRI Assessment / Observation standards Review Broncho-pulmonary assessment in Optimus Define guidelines for staff Communication Build Profile order set Management of URI –Nursing orders Assess Bronchopulmonary status BID and prn Provide additional fluids Encourage coughing and deep breathing Encourage mobility Monitor VS and O2 Sat BID and prn –Physician orders IV fluids Antibiotic therapy Oxygen therapy Nebulizer treatments Portable CXR CBC BMP

8. 8 Process (cont.) CARE PATH: Symptoms of Lower Respiratory Infection (INTERACT II ) –SBAR Communication as a guide to communication with physician Education Develop powerpoint education tool covering the steps defines in Assessment and Communication Skills training –Completing a respiratory assessment Equipment: Lung sound recordings, Double ear stethoscope –Understanding the findings of the assessment Monitoring Track hospitalizations and review using Quality Improvement Tool (INTERACT II ) Report quarterly and include in quality Dashboard

9. 9 Staff Education

10. 10 Assessing Lung Sounds http://www.easyauscultation.com/lung-sounds.aspx http://www.wilkes.med.ucla.edu/lungintro.htm http://www.cvmbs.colostate.edu/clinsci/callan/breath_ sounds.htm http://faculty.etsu.edu/arnall/www/public_html/heartlu ng/breathsounds/contents.html

11. 11 Challenges and Successes

12. 12 Data Findings Re-Hospitalization Rates

13. The Next Step… Partnering with Hospitals