The Portal of Geriatrics Online Education

Caring for the Older Adult

Gait Velocity Assessment Toolkit

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

Gait Velocity is a marker of functional and cognitive status in older adults.  Slow gait speed has been associated with poor clinical outcomes such as cognitive decline, falls and hospitalization. This toolkit provides  instructions on how to perform a gait speed or gait velocity assessment.  It includes START and STOP labels, labels for the Timed Zone, and instructions on how to interprete and apply the results.  The examiner will need to measure and mark a walkway, and supply a stopwatch or watch with a second hand. By following these simple steps, gait velocity assessment can become a routine practice for clinicians who care for older adults.

Educational objectives: 

1. Describe how to perform and interpret gait velocity assessment in older adults.

2. Discuss the clinical implications of slow gait speed

Date posted: 
Fri, 10/09/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 04/13/2018
Contact Person/Corresponding Author:



Suggested Citation:
Gait Velocity Assessment Toolkit. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

Geriatric Fast Facts Quizzes

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

Geriatric Fast Facts (GFFs) [www.geriatricfastfacts.com] is a mobile enabled website which contains 1-2 page concise, peer-reviewed evidence-based educational summaries on key geriatrics topics to increase medical knowledge.

GFF Quizzes are quick, online assessment tools paired with GFF content, to be used by learners at the point of care to assess knowledge of geriatric content aligned with ACGME Milestones.  Design elements include quiz content searchable by topic, links to corresponding GFFs, MCQ/ short answer question formats and ability to include images. Learners enter brief demographic information to start (institution, email of self and up to 1 other) allowing annotated score results, displayed immediately after quiz completion, to be sent to themselves and one other individual (faculty, program director). These quick quizzes, available on hand held mobile devices at the point of care, linked to GFF content provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Educational objectives: 

The Geriatric Fast Fact (GFF) quizzes, available on hand held mobile devices at the point of care, linked to GFF content will provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Additional information/Special implementation requirements or guidelines: 

The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed and accessed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app".

Publications from, presentations from, and/or citations to this product: 

Quick Quizzes:  Geriatrics Right in Your Hand & at the Point of Care.  Denson K, Simpson D, Padua K, and the GET Collaboratives at the Medical College of Wisconsin & Aurora Health Care, American Geriatrics Society Annual Meeting, Baltimore, MD, 05/2015

Date posted: 
Thu, 10/08/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/08/2015
Product Viewing Instructions: 
The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app"
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Fast Facts Quizzes. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

This two hour interprofessional curriculum brings together fourth year medical students and third year pharmacy students in a hands-on, interactive small group session. Learners are given a guide briefly describing the case and delineating five health care members and their roles and expertise in Mr. Moore's healthcare team (Mr. Moore's partner, the outpatient pharmacist, the inpatient intern, etc). A pair of interprofessional facilitators guide learners through the case, utilizing different healthcare team members' roles and expertise to explore methods of medication organization and systemic barriers to accurate and safe discharge medication reconciliation. Learners discover and discuss discrepancies in high-risk medications, gain an appreciation of systems hurdles for patients and healthcare providers during transitions of care, complete an exercise in writing discharge medication instructions, and brainstorm action items to personally employ to overcome systemic hurdles for safer discharge medication reconciliation.

Educational objectives: 

By the end of the two-hour session, learners will work collaboratively to:

  1. Describe the roles and expertise of three health professions that can collaborate to reconcile medications and enhance safety of medication orders at the time of hospital discharge. 
  2. List three potential communication barriers between health professionals involved in discharge planning that contribute to medication errors in vulnerable older adults.
  3. Identify key components of discharge medication lists and instructions to communicate information safely to patients, caregivers, primary care providers and others on the healthcare team.
Date posted: 
Tue, 08/30/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/30/2016
Contact Person/Corresponding Author:



Suggested Citation:
"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1052

Error Disclosure: An Interprofessional Clinical Skills Session

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
1
Abstract: 

The goal of this clinical skills session is for students to gain skills in working in teams during a particularly difficult situation: the team disclosure of medical errors.  There will be an encounter with a standardized patient (SP) acting as a family member, followed by feedback from the SP and for some students, a review of the recorded interview in a meeting with their mentors and mentor group.

Educational objectives: 

At completion of this case, the student will demonstrate effective team communication behaviors when:

  1. Discussing a medical error (by demonstrating four important principles),
  2. Planning for the disclosure (by demonstrating three important principles), and
  3. Conducting the disclosure (by demonstrating eight important principles).

The principles mentioned above are described in the online module.

Date posted: 
Mon, 10/12/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/12/2015
Product Viewing Instructions: 
Video can be accessed via geriSAGE.com>Educational Modules "Interprofessional web-GEM on Values & Ethics". Handout can be accessed on geriSAGE.com>Resources link>"IP Error Disclosure Handout"
Contact Person/Corresponding Author:



Suggested Citation:
Error Disclosure: An Interprofessional Clinical Skills Session. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

Interprofessional Grand Rounds

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

The Rowan University School of Osteopathic Medicine, together with the Rutgers University School of Nursing, and Rutgers School of Health Related Professions, piloted an interactive, team-based “Interprofessional Grand Rounds” as an instructional strategy to promote interprofessional care plan development and enhance understanding of roles and responsibilities across disciplines.  A total of 235 nursing, physical therapy, respiratory therapy, and medical students collaborated in small groups to problem-solve a complex, multi-faceted case presented with video elements to facilitate gait analysis.  Students answered case study questions using an innovative scratch-off ticket technique.  A team of interdisciplinary faculty facilitated the case-based group discussions. 

Educational objectives: 
  • Explain the importance of effective team communication in a healthcare setting
  • Stimulate team skills in respectful communication and cooperation by creating collaborative interprofessional groups
  • Report increased knowledge of other health care professions and individual confidence in taking an active role as a member of an interprofessional team
Additional information/Special implementation requirements or guidelines: 

Students were seated in small groups of 5 to 7 students representing different health care professions.  This design created a collaborative atmosphere and allowed open communication among the students from all professions.

  • Chairs in clusters (no tables)
  • Mixture of team members from each health care profession
  • Typical team composition: 3 to 5 Medical Students, 1 Nursing student, 1 to 2  Physical Therapy students, and 1 Respiratory Therapy student
Date posted: 
Mon, 10/12/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/12/2015
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Grand Rounds. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

Palliative Care Case

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Product Information
Estimated time to complete: 
3
Abstract: 

Using a case study participants will follow an older patient who requires increasing levels of care. After breaking into interdisciplinary teams led by leaders in transitions of care, participants will discuss goals, long-term care planning, and transitions in and out of hospital.

 

Educational objectives: 

Upon completion participants will be able to:

  • Describe how a multidisciplinary team approach enhances quality of life for patients throughout the aging process.
  • Recognize the importance of understanding a patient’s values, goals, and beliefs while assisting with transitions of care and long-term care planning.
Date posted: 
Wed, 09/30/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 09/30/2015
Contact Person/Corresponding Author:



Suggested Citation:
Palliative Care Case. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

Geriatricized H&P with Function and Delirium Risk Assessments

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
0
Abstract: 

One important goal of the Wake Forest Geriatrics Principles for Specialists program is to train faculty, chief residents and fellows in the use of quality improvement techniques to enhance care for older adult patients that they serve.  As a product of this effort, chief residents and their faculty mentors in General Internal Medicine developed functional assessment and delirium risk assessment tools that have been incorporated into the history and physical template of the electronic medical record (EMR) to identify pre-hospital functional and cognitive limitations that affect admitted patients age 65 or older.  At present these tools are found in the note template of the following services: four general medicine teaching services, two cardiology services, the renal service, the hematology oncology service, the leukemia service, the Acute Care for the Elderly service, the cardiac critical care service, and the medical intensive care service. 

The functional assessment, implemented in July 2014, includes four questions to help determine a patient’s baseline functional status, including ability to complete activities of daily living and independent activities of daily living, ambulation status, and pre-hospital residence.  Analysis involving chart reviews pre-and post- functional assessment tool implementation showed increased documentation of functional history data in the EMR. 

The delirium risk assessment, implemented in July 2015, includes four items to help identify a patient’s cognitive status, including age greater than 80, a reverse spelling task, orientation to location, and illness severity.  Analysis of delirium incidence of hospitalized patients pre- and post- delirium risk tool implementation is planned for fall 2015.  Our hypothesis is that delirium incidence will rise as awareness and watchfulness by providers increases with use of the tool. 

While the results of implementing these physical and cognitive assessment tools are preliminary or still in process, anecdotal feedback received from case managers and other stakeholders in the discharge planning process indicate that they find such information incorporated in the H&P by admitting physicians to be valuable.  Further study is needed to determine whether such documentation expedites discharge planning, improves use of therapy services, or improves readmission rates or morbidity outcomes.  Next steps planned beyond testing of the delirium assessment tool include implementing a delirium prevention order set to standardize measures taken to decrease delirium among inpatients, followed by further evaluation of changes in delirium incidence, and eventual implementation of a delirium management order set.  The success of these measures within Internal Medicine could encourage roll-out of these tools institution-wide.

An additional benefit of this effort has been the educational value of supporting the training of residents in informatics so that they can contribute to developing solutions for improving patient safety and quality of care.  

Educational objectives: 
  1. To train residents and faculty in quality improvement techniques for the purpose of enhancing quality of care and patient safety for older adult patients.
  2. To involve residents in developing EMR tools that emphasize the importance of physical and cognitive assessments when admitting older adult patients to the hospital.
  3. To provide training opportunities in EMR informatics for residents and junior faculty.
Publications from, presentations from, and/or citations to this product: 

M. Wesley Milks, Farra Wilson, Ajay Dharod and Kirsten Feiereisel.  Abstract 347:  Identification of Functional Limitations on Admission by Internal Medicine Resident Physicians.  Circulation: Cardiovascular Quality and Outcomes. 2015;8:A347.

Contact Person/Corresponding Author:



Suggested Citation:
Geriatricized H&P with Function and Delirium Risk Assessments. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

SAGE Intrinsic Aging: A Histological Perspective: Musculoskeletal System

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
1
Abstract: 

This module demonstrates the normal age-related changes in the musculoskeletal system and their clinical implications. A highlight of these modules are side by side comparisons of young and aged tissues with interactive slides and summary drawings which reinforce the main points on the histology slides. The curriculum is appealing to clinical learners as it is anchored in showing clinically relevant changes and the implications of these changes in older patients. The main audience is the pre-clinical first or second year medical student, but these could be used by other trainees to teach the basic science of aging.

Educational objectives: 

Learning Objectives for Musculoskeletal System module:

Identify the major aging associated changes in each of the following and describe the clinical implications of these changes:

  1. Muscle
  2. Tendons & ligaments
  3. Cartilage
  4. Bone
  5. Spine
Additional information/Special implementation requirements or guidelines: 

Southwestern Aging and Geriatrics Education (SAGE) Program

Lead Author: Judith R. Head, PhD

Medical Illustrator: Lindsay Oksenberg, MA

Geriatrician Author/Clinical Correlations: Amit Shah, MD

Special thanks to histology technicians: Brie Thaden Pirkle and Tasha Buxton

Date posted: 
Wed, 12/09/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 12/09/2015
Contact Person/Corresponding Author:



Suggested Citation:
SAGE Intrinsic Aging: A Histological Perspective: Musculoskeletal System. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

Surgical Palliative Care Immersion Training

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
999
Abstract: 

We developed a mandatory Surgical Palliative Care Immersion Training (SPCIT) for all surgical residents.  It was modeled after the Chief Resident Immersion Training (CRIT) Program and included ½ day interactive small table, facilitated case based discussion, with mini-lectures, and role play.  Our program includes a needs survey, the agenda, cases, power points for mini-lectures, instructions for role and just-in-time reference cards for delivering bad news and determine goals of care. 

Educational objectives: 

To describe the role of palliative surgery and symptom management

To demonstrate ability to communicate goals of care discussion

To demonstrate ability to deliver bad news

    

Date posted: 
Mon, 10/10/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/10/2016
Contact Person/Corresponding Author:



Suggested Citation:
Surgical Palliative Care Immersion Training. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1052

Assessing Capability of Medical Decision Making Capacity

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

A multifacted program focused on Assessment of Medical Decision Making Capacity. It includes the following education and assessment tools:

 

  • Elder Care Provider Sheet, “Medical Decision-Making Capacity”
  • A needs assessment for all medical and surgical specialties
  • Just-in-time reference cards
  • Mini-CEX to assess residents

 

Educational objectives: 

Determine if the patient has the:

  • Ability to clearly communicate their choice for treatment or non-treatment
  • Ability to understand the relevant information (regarding medical condition and treatment)
  • Ability to understand the situation and the consequences of treatment options
  • Ability to reason about treatment choices, consistent with personal values

 

 

Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatric Education Center."
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.               

Date posted: 
Mon, 09/28/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 03/29/2018
Contact Person/Corresponding Author:



Suggested Citation:
Assessing Capability of Medical Decision Making Capacity. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/1052

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