OPTIMISTIC is a comprehensive initiative funded by Centers for Medicare and Medicaid services, to enhance care in Indiana nursing homes under the leadership of Dr. Greg Sachs, Dr. Kathleen Unroe, and Dr. Arif Nazir with the Indiana Universtiy Center for Aging Research and the Indiana University Division of General Internal Medicine and Geriatrics. Together with our local partners, including the University of Indianapolis Center for Aging and Community, we are well positioned to lead a demonstration and evaluation initiative aimed at avoiding inappropriate or unnecessary hospitalizations of long stay nursing facility residents.
OPTIMISTIC is a multi-component program to support nursing facilities in redesigning and improving care delivery processes.
OPTIMISTIC is operationalized through the addition of specially trained registered nurses (RNs) who are stationed on-site at each of the nursing facilities. These nurses will provide direct support, education and training to the staff at each facility and lead care management reviews of long stay patients to optimize chronic disease management, reduce unnecessary medications, and clarify goals of care.
Many of the processes to enhance care through the OPTIMISTIC program are derived from "INTERACT" which provides established evidence-based methods and tools designed to reduce hospitalizations of nursing home residents. The INTERACT website can provide more details about the tools and methods that will be introduced into our facilities.
OPTIMISTIC will increase capacitities to respond to changes in medical condition by focusing on early recognition of acute changes in symptoms, early triage and treatment, and efficient communication with other providers.
OPTIMISTIC will enhance patient-centered care by integrating palliative care concepts including:
a. Education for patients, families, staff, and providers;
b. Implementation of a comprehensive advance care planning process;
c. Improved access to pain and symptom management.
OPTIMISTIC leadership and staff are ready to help you find more information!
Laura Holtz - Project Manager
Helen Maurer - Project Coordinator
Centers for Medicare and Medicaid Services
Through this initiative, CMS will partner with eligible, independent, non-nursing facility organizations (referred to as “enhanced care & coordination providers”) to implement evidence-based interventions that reduce avoidable hospitalizations. Eligible organizations can include physician practices, care management organizations, and other entities. Both for-profit and not-for-profit organizations are eligible to apply.
The enhanced care & coordination providers will collaborate with States and nursing facilities, with each enhanced care & coordination provider implementing its intervention in at least 15 partnering nursing facilities.
Applicants will propose an intervention that meets the objectives of the initiative, which those selected will then implement. Interventions will be evaluated for their effectiveness in improving health outcomes and providing residents with a better care experience.