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.