Specialty care delivery: bringing infectious disease expertise to the residents of a Veterans Affairs long-term care facility

J Am Geriatr Soc. 2013 May;61(5):782-7. doi: 10.1111/jgs.12206. Epub 2013 Apr 16.

Abstract

Objective: To initiate a long-term care facility (LTCF) infectious disease (LID) service that provides on-site consultations to LTCF residents to improve the care of residents with possible infections.

Design: Clinical demonstration project.

Setting: A 160-bed LTCF affiliated with a tertiary care Veterans Affairs (VA) hospital.

Participants: Residents referred to the LID team.

Measurements: The reason for and source of LTCF residents' referral to the LID team and their demographic characteristics, infectious disease diagnoses, interventions, and hospitalizations were determined.

Results: Between July 2009 and December 2010, the LID consultation service provided 291 consultations for 250 LTCF residents. Referrals came from LTCF staff (75%) or the VA hospital's ID consult service (25%). The most common diagnoses were Clostridium difficile infection (14%), asymptomatic bacteriuria (10%), and urinary tract infection (10%). More than half of referred residents were receiving antibiotic therapy when they first saw the LID team; 46% of residents required an intervention. The most common interventions, stopping (32%) or starting (26%) antibiotics, were made in accordance with principles of antibiotic stewardship.

Conclusion: The LID team represents a novel and effective means to bring subspecialty care to LTCF residents.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Delivery of Health Care / organization & administration*
  • Hospitalization / statistics & numerical data*
  • Hospitals, Veterans*
  • Humans
  • Infections / epidemiology
  • Infections / therapy
  • Long-Term Care / methods*
  • Morbidity / trends
  • United States / epidemiology
  • Veterans*