Do internal medicine residents know enough about skilled nursing facilities to orchestrate a good care transition?

BACKGROUND

Although many older adults require skilled nursing facility (SNF) care after acute hospitalization, it is unclear whether internal medicine residents have sufficient knowledge of the care that can be provided at this site.

METHODS

We developed a 10-item multiple choice pre-test that assessed knowledge of the definition of a SNF, SNF staffing requirements, and SNF services provided on-site. The test was administered to trainees on the first day of a mandatory SNF rotation that occurred during their first, second or third year of training.

RESULTS

Sixty-seven internal medicine residents [41 postgraduate year (PGY)-1, 11 PGY-2, and 15 PGY-3] were assessed with the test. The mean number of questions answered correctly was 4.9, with a standard deviation of 1.6. Regardless of their level of training, residents had a poor baseline knowledge of SNF care (mean scores 4.2 for PGY-1, 5.3 for PGY-2, and 6.3 for PGY-3) (P < .0001). Performance on some questions improved with increased level of training but others did not.

CONCLUSIONS

Medical residents have insufficient knowledge about the type of care that can be provided at a SNF and efforts to improve this knowledge are needed to assure proper triage of patients and safe transitions to the SNF.