INTERACT® is an acronym for “Interventions to Reduce Acute Care Transfers.” The interventions is a quality improvement program designed to
improve the identification, evaluation, and communication about changes in resident status. INTERACT® was first designed in a project supported by the Centers for Medicare and Medicaid Services (CMS). Now, many post-acute providers across the U.S. are using INTERACT®.

What is the purpose of the INTERACT Quality Improvement Program?

The overall goal of the INTERACT® program is to reduce the frequency of transfers to the acute hospital. Transfers to the hospital can be emotionally and physically difficult for residents, and result in numerous complications of hospitalization, and they are costly.

In the plans for health care reform, Medicare may financially reward facilities with lower hospitalization rates for certain conditions. By improving the identification, evaluation, and communication about changes in resident status, some, but not all acute care transfers can be avoided.

What are the INTERACT® Tools?

There are four basic types of tools:

  1. Quality Improvement tools 
  2. Communication tools
  3. Decision Support tools
  4. Advance Care Planning tools

The specific tools are designed for use by selected members of the care team. However, in order for the INTERACT® team to be successful, all members of the care team should be aware of all of the tools and their uses. The INTERACT® project champion will assist your team in using the tools on a daily basis. The tools have been designed to help staff improve care, but not increase unnecessary paperwork. To view and download, go to INTERACT® Tools >


The INTERACT® Project Team

Joseph G. Ouslander, M.D. – (Project Director for INTERACT® and Senior Medical Advisor for Pathway Health) – Dr. Ouslander is Professor and Associate Dean for Geriatric Programs at the Charles E. Schmidt College of Medicine, Chair of the Integrated Medical Science Department, and Courtesy Professor at the Christine E. Lynn College of Nursing of Florida Atlantic University in Boca Raton Florida. 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 an editor of Hazzard’s Geriatric Medicine and Nursing Home Care.

Bernardo Reyes, M.D. – Dr. Reyes is an Assistant Professor at the Charles E. Schmidt College of Medicine Florida Atlantic University where he also serves as Assistant Program Director for the Internal Medicine Residency Program. Dr. Reyes completed his fellowship in Geriatric Medicine at Harvard University, where he directed a hip fracture co-management service at Massachusetts General Hospital. Dr. Reyes is an expert in fragility fractures and hip fracture management, as well as care transitions.

Jill Shutes, G.N.P. – Ms. Shutes is a geriatric nurse practitioner with over 25 years of nursing experience. She graduated from Rutgers College of Nursing with a Bachelors of Science in Nursing in 1987. She graduated from the University of Massachusetts in 1997 with a Masters of Science in Nursing. She has extensive experience in post-acute and long-term care. She works at Florida Atlantic University as a Program Coordinator on projects with Dr. Ouslander in relationship to the INTERACT Quality Improvement Program. She is also Assistant Professor in the Doctoral Nursing Program for Palm Beach Atlantic University.

Gabriella Engstrom, R.N., Ph.D., is a visiting faculty member at the Charles E. Schmidt College of Medicine. She previously served on the Faculty of Medicine at Uppsala University and Assistant Dean, Malarden University in Sweden. She has been the project coordinator for an NIH-supported implementation trial of the INTERACT Quality Improvement Program as well as on the STAR Quality Improvement Program, and has extensive experience and expertise in data collection and management.

Sanya Diaz, M.D., N.P. – Dr. Diaz received her Medical Doctor degree in 2002 from Universidad Mayor de San Andres in La Paz-Bolivia and her Nurse Practitioner degree from Florida International University. Currently she is a Research Associate for the Charles E. Schmidt College of Medicine at Florida Atlantic University where she assists with the quality improvement and research activities, including the INTERACT® and the STAR Quality Improvement Program.


Contact us to learn how INTERACT® can assist your organization improve hospital readmission rates and improve overall efficiencies.