The Portal of Geriatrics Online Education

Family Medicine

"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/201

Interprofessional Grand Rounds

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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: 

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/201

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/201

Geriatricized H&P with Function and Delirium Risk Assessments

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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: 
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/201

Assessing Capability of Medical Decision Making Capacity

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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/201

Elder Care A Resource for Interprofessional Providers: Medical Decision-Making Capacity

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

Medical Decision-Making Capacity is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 
  1. Explain the difference between “capacity” and “competence.”
  2. Make a determination medical decision making capacity with a formal assessment tool.
  3. Explain why poor performance on a mental status examination does not necessarily indicate lack of decision-making capacity.
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: 
Wed, 04/22/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 03/06/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Medical Decision-Making Capacity. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/201

Physical Therapists Optimize Movement

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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 resident education module was developed to educate residents on what other team members do.  The content was organized around the IM-FM geriatric competencies and IM Milestones.  The focus of this module is an introduction to the physical therapy profession as a whole with a perspective on its role in health care.  The module outlines the education and training received by professional physical therapists, as well as by physical therapy aides.  Important clinical problems will be described that benefit from physical therapy referral.  The overall therapy process used by physical therapists in caring for patients, starting from their first meeting, is mapped out in this module.  

Educational objectives: 

1. Introduction to the PT profession, its role in health care

2. Outline education and training

3. Review clinical problems that merit referral to PT

4. Map out overall therapy process employed in patient care

Date posted: 
Tue, 08/18/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/18/2018
Product Viewing Instructions: 
Turn on the volume to your device before viewing the module. Allow a few seconds for the module to load.
Contact Person/Corresponding Author:



Suggested Citation:
Physical Therapists Optimize Movement. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/201

Interprofessional Collaborator Mini-Course

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

Physicians (and other health professionals) are often expected to participate with teams of health professionals; however, postgraduate training infrequently includes interprofessional (IP) or team training.  Thus, this curriculum was developed to teach and demonstrate the knowledge, skills and attitudes which lead to successful IP collaboration.  While created for an audience of in-training physicians, it may be used with other health professional audiences.

During a four-week geriatrics rotation, medicine interns complete a fifty-minute, in-person, multimedia lecture to introduce the IP collaborator concept and the Canadian and American IP competency frameworks. The IP pocket card is demonstrated and interns complete a guided, team-meeting video observation exercise. Using a SurveyMonkey, narrative reporting tool, interns analyze team competencies that they observe or initiate during geriatrics team meetings during the rotation. They report on two interactions. They complete a closing SurveyMonkey questionnaire and have an in-person debriefing.

Educational objectives: 

Given opportunity to work with interprofessional teams for patient care on the Geriatrics Block Rotation:

  • Learner will recognize interprofessional competencies.
  • Learner will understand the role of interprofessional collaborator.
  • Learner will observe and demonstrate the knowledge, skills and attitudes necessary to be an interprofessional collaborator according to CIHC and IPEC competencies
Publications from, presentations from, and/or citations to this product: 
Poster Presentation: Interprofessional Collaborator Curriculum
InterProfessional Care for the 21st Century
Redefining Education & Practice
Jefferson University, Philadelphia, PA
October 2014
Date posted: 
Tue, 06/14/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 06/14/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Collaborator Mini-Course. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/201

It Takes a Village: Interprofessional Geriatrics Case Conference

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

Residency programs are grappling with the best ways to improve their curriculua to meet the requirements of the Next Accreditation System and ACGME Milestones.  Our review identified NAS requirements that align with established geriatrics care principles (e.g., transitions of care, interprofessional teamwork, managing complex patients, patient / caregiver communication).  Our internal medicine residency program transformed an existing monthly, hour long educational case conference into an an interdisciplinary team-based educational forum emphasizing key geriatrics care and interprofessional principles.  This educational product includes all tools and information necessary for this session to be successfully implemented and evaluated in other institutions.  

Materials and information includes:

  1. Outline / identification of interdisciplinary participants
  2. Forum structure and format 
  3. Content area examples
  4. Learner and curriculum evaluation tool. 

This session provides tools for learners to reach these training goals and requirements while integrating core geriatrics principles through use of team teaching with interprofessional colleagues.  Learners consistently reported an increase in knowledge gained in all targeted milestones with the most dramatic increases in milestones specific to systems-based practice and professionalism.

Educational objectives: 
  1. Integrate interprofessional colleagues into internal medicine residency education in a meaningful forum.
  2. Demonstrate how interprofessional collaboration and communication leads to higyh quality patient care through the use of practical patient cases with evidence to support key points drawn from the literature.
  3. Emphasize core geriatric syndromes and principles that are often overlooked or missed.

 

Additional information/Special implementation requirements or guidelines: 

Please see the attached Instructor's Guide for full implementation details and guidelines for the session.

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

Abstract/Poster Presentation: Kuester J, Carnahan J, Duthie E, Rehm J, Denson S, Duthie E Jr, Integration of ACGME Milestones into Internal Medicine Residency Curriculum Through Teaching Care Geriatric Principles, American Geriatrics Society Annual Meeting, Orlando, FL, 05/2014.

Date posted: 
Thu, 10/01/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/01/2015
Contact Person/Corresponding Author:



Suggested Citation:
It Takes a Village: Interprofessional Geriatrics Case Conference. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/201

A Developmental Approach to Campus-Wide Interprofessional Education: From Exposure to Immersion using a Geriatric Case Study

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

This session will provide health professions students the opportunity to become immersed in a realistic interrprofessional (IP) care planning activity for an older adult.  The primary purpose of this session is to provide a health care specific experiential learning opportunity through which students may better understand the challenges of and develop skills for working with an interprofessional health care team.  The secondary purpose of the session is to provide an opportunity for students to better understand the roles of different health care professions early in their career.

Educational objectives: 

During this small group activity, student participants will:

1. Develop an interprofessional care plan by integrating their own discipline's plan with that of students from other professions.

2. Identify three types of professional competencies: (1) complementary individual professional competencies that are unique to a profession; (2) common clinical competencies that are held by more than one profession; and (3) interprofessional collaborative competencies such as team skills, communication skills, and an understanding of roles and responsibilities.

3. Use the SBAR tool to structure interprofessional communication and communicate essential information to team members about a patient.

4. Improve their orientation toward interprofessional team-based care as compared to multidisciplinary care.

Date posted: 
Tue, 08/18/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/18/2015
Contact Person/Corresponding Author:



Suggested Citation:
A Developmental Approach to Campus-Wide Interprofessional Education: From Exposure to Immersion using a Geriatric Case Study. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/201

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