Dr. Ouslander's Research
Joseph G. Ouslander, M.D., Professor of Geriatric Medicine in FAU's Charles E. Schmidt College of Medicine has made many contributions to the field of geriatric medicine.
Learn more about his research.
Interventions to Reduce Acute Care Transfers or INTERACT is a quality improvement program that assists long-term care facilities and programs in improving care, and reducing unnecessary hospitalizations. Dr. Ouslander and Ruth Tappen, Ed.D., R.N., co-director and Eminent Scholar in the Christine E. Lynn College of Nursing received nearly $7 million dollars in several grants and contracts from various federal and private agencies including the National Institutes of Health (NIH) and Centers for Medicare & Medicaid Services to further develop, disseminate and evaluate the impact of INTERACT.
INTERACT was first designed as a project supported by the Centers for Medicare and Medicaid Services (CMS) and further tested in a project supported by the Commonwealth Fund under Dr. Ouslander's leadership. The program was initially implemented at 25 community-based nursing homes in Florida, Massachusetts and New York over a six-month period and resulted in a 17 percent reduction in hospital admissions among the residents. The reduction was even greater in homes that were most engaged in implementing the INTERACT intervention. The tools target three key strategies to reduce potentially avoidable hospitalizations: preventing conditions from becoming severe enough to require acute hospital care; managing selected acute conditions in the nursing home; and improving advance care planning for residents among whom a palliative or comfort care plan, rather than acute hospitalization, may be appropriate. Using INTERACT's standardized protocol and working with an on-call nurse practitioner who visits the nursing home daily, the patient can be treated in the nursing home without any complications and only costing Medicare about $200 instead of $10,000 or more. Using such care in nursing homes nationwide could improve care, reduce complications from hospitalizations, and avoid hundreds of millions of dollars in Medicare expenditures annually.
In summer 2012, FAU's Charles E. Schmidt College of Medicine announced the introduction of a joint initiative with PointClickCare, the long-term care industry's most widely used Electronic Health Record (EHR) platform, to develop a fully integrated, electronic version of the INTERACT quality improvement program – eINTERACT™. The primary goal of the initiative is to bring the significant quality improvements of the INTERACT program to EHR software platforms through an industry-standard certification program. More information on eINTERACT is available at www.einteract.info/.Â
Charles E. Schmidt College of Medicine and the Christine E. Lynn College of Nursing are actively engaged in projects and studies that explore improvements in quality of life and quality of health care services for older adults. The interdisciplinary team received funding via an FAU research priority award for a longitudinal study that is focusing on the keys to successful aging in the older population in the South Florida region.
Joseph G. Ouslander, M.D., Chair of the Integrated Medical Science Department and Senior Associate Dean of Geriatric Programs in the Charles E. Schmidt College of Medicine and Ruth Tappen, Ed.D., R.N., Eminent Scholar and Distinguished Professor from FAU’s Christine E. Lynn College of Nursing are leading the study, which includes investigators from eight colleges at FAU. The team is assessing older individuals from four ethnic groups— two immigrant and two nonimmigrant— who are living in older adult communities in Palm Beach, Broward and Miami-Dade counties.
The research team values the opportunity to immerse themselves in these communities to talk with and learn from four specific groups: fourth generation European-Americans and African-Americans and first generation Afro-Caribbean and Hispanic-Americans.
One hypothesis they are testing is whether immigrants tend to be healthier and more resilient than those who have lived in the United States for generations. The team is seeking answers to questions, such as:
- How does the impact of aging differ between cultures?
- How does it differ between immigrants and those who have been here for generations?
- Do diverse cultures have the same goals and the same wishes as they age, or are they different?
The study results will bring health care professionals a step closer to understanding the science of how people can live better and longer; what health care professionals can do to contribute to quality aging; and what older people and their caregivers can do to enhance the quality of their aging.
INTERACT and Healthy Aging Research Initiative (HARI) Project Directors:
Joseph. G. Ouslander, M.D. is the Chair of the Integrated Medical Science Department and Senior Associate Dean for Geriatric Programs in the Charles E. Schmidt College of Medicine, and Professor at the Christine E. Lynn College of Nursing at Florida Atlantic University. Dr. Ouslander served as a Professor at UCLA for 15 years developing research, educational, and clinical programs. From 1996-2007 he served as the Director of Geriatric Medicine at Emory University. He is a past-President and Board Chair of the American Geriatrics Society, and serves as the Executive Editor of the society's Journal. He is a co-author of Essentials of Clinical Geriatrics and Medical Care in the Nursing Home, and an editor of Hazard's Geriatric Medicine and Gerontology.
Ruth Tappen, Ed.D., R.N., F.A.A.N. is an Eminent Scholar and a Distinguished Professor of Nursing in the Christine E. Lynn College of Nursing at Florida Atlantic University. She is a nationally known scholar and researcher in aging, and has been funded by the NIH, HRSA, AoA, major foundations, and others. She served as FAU's acting Vice President of Research for two years and was the founder of the Louis and Anne Green Memory and Wellness Center at FAU, a state-designated memory disorder center. Her research has addressed a range of issues related to aging with emphasis on exercise, communication and cognitive retraining therapies. Her book, Advanced Nursing Research: From Theory to Practice, reflects her expertise in research design analysis and psychometric evaluation.
Safe Transitions for At Risk Patients or the “STAR Program” is a quality improvement program that focuses on the patient safety problem of potentially preventable hospital readmissions among older adults at high risk of complications during hospitalization and transitions between care settings. The project is supported by the Florida Medical Malpractice Joint Underwriting Association.
The STAR Program builds on previously tested care transitions programs by targeting high risk patients age 75 and older and employing a multicomponent, interdisciplinary intervention. In addition to identifying high-risk older patients, the program includes: an in-hospital geriatric assessment that results in care transition recommendations; a pre-discharge visit by a nurse to enhance case management education and discharge planning; follow up in person and by telephone by a nurse or nurse practitioner to identify unmet needs and assess adherence to recommendations, and communicate with the patient’s physicians if indicated; and providing training and support for post-acute care organizations to implement the Interventions to Reduce Acute Care Transfers (INTERACT) program.
The STAR Program is a collaboration between FAU, acute care hospitals, and post-acute care organizations. It can serve as a critical resource for inter -professional education on patient safety and quality for FAU medical students and residents, hospital staff, and local post-acute care providers that participate in a Post -Acute Care Transition Quality Consortium. The program will also result in the development of a quality improvement patient safety database on high-risk older patients that can be incorporated into electronic medical records and provide data for student, resident, and faculty scholarly work. The program will also provide quality and patient safety data and lessons for evolving programs in value based care, including bundled payments, ACOs, and other local, state and national payment reform initiatives.