The Portal of Geriatrics Online Education

Care Settings & Models

Barney Smith 3 - A Transitions of Care Interprofessional Education Standardized Patient

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Product Information
Abstract: 

This transitions of care Interprofessional education standardized patient serves to train Year 3 medical students and graduate students from physical, occupational and speech therapy in the transition of care of a frail older adult from the hospital to home. It is the third of a six part progressive standarized patient encounter on palliative care. This clinical simulation is an encounter with Barney as a hospitalized patient with newly acquired functional decline. Learners gain experience in the interprofessional team assessment of a hopsitalized older adult's functional status and the team management of that patient's transition of care from the hospital to home. Educational modalities include web-based instruction , the simulation, and a small group discussion of the interprofessional set of learners immediately following the encounter facilitated by interprofessional faculty.  

Educational objectives: 

1) Perform an interprofessional, comprehensive team assessment of a hospitalized older adult's functional assessment and the team mangement of that patient's transition of care from the hospital to home. 

2) Understand the role that individual discpliness play in conducting  a comprehesive assessment of an older adult's functinal status 

3) Assess specific risks and barriers to older adult safety as they transition from the hospital to home 

4) Assist family caregivers in identfying caregiver responsibilities and potential caregiver burden 

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Barney Smith 3 - A Transitions of Care Interprofessional Education Standardized Patient. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

The Hospitalized Older Adult

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

Older adults are exposed to multiple hazards during hospitalization resulting in multiple complications that limit their return to their functional and cognitive baseline. It is critical that healthcare providers are trained on best practices in the care of hospitalized older adults. This product is a monthlong module for M4 students during their Sub I rotation, that focuses on educating them on the hazards of hospitalization, best practices in the care of hospitalized older adults, issues that occur during transitions of care and best practices to ensure optimal transitions across care settings. The module starts with an initial lecture on hazards of hospitalization and best practices in the care of older adults. This is followed by assignments in which students are assigned older aduts to care for. Using a checklist, they evaluate the care that these patients have received and also implement best practices in the care of their patient. They also participate in an interdisciplinary team meeting that focuses on these aspects of care.  This is followed by another assignment in which they are involved in deciding on the most appropriate discharge care setting their patient. They subsequently place a post discharge call to their patient to identify any issues thay may have encountered post discharge and assist them in resolving some of these issues. Through the month, students share their experiences on blackboard, outlining hazards they identified in their patients,  challenges in implementing best practices, choice of discharge care setting and reasons for their choices along with care transitions issues identified in their patients. Additionally they are required to review educational materials and published articles posted on blackboard, focused on hazards of hospitalization, best practices in care, settings of care and transitions of care.  A final class is held with the students at the end of the month discussing the rotation and their experiences, with a focus on settings of care and best practices in transitions of care.

Educational objectives: 

At the end of this course, each participant will be able to:

1. Describe the hazards of hospitalization of older adults.

2. Evaluate the care and implement best practices in the management of a hospitalized older adult.

3. Enumerate the discharge options available in a particular case scenario.

4. Compare and contrast the problematic elements of care transition with those of an ideal care transition.

Date posted: 
Tue, 10/25/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 10/25/2016
Contact Person/Corresponding Author:



Suggested Citation:
The Hospitalized Older Adult. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

Interprofessional Geriatric Education and Training in Texas: Seniors Assisting in Geriatric Education - Interprofessional Team-Based Training, Assignments & Grading

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

The Seniors Assisting in Geriatric Education (SAGE) program consists of an educational curriculum and community based outreach program aimed at increasing student opportunities for early exposure to older adults and issues of geriatrics. The program strives to create meaningful relationships for the interprofessional teams of students while gaining knowledge about today’s senior population and their needs. The educational component involves health care profession students interacting with each other and their senior mentor through structured assignments delivered in the home environment.

Student teams are paired in groups of 3-4 healthcare profession students. The student teams are then matched with a community-dwelling senior who receives services from Meals on Wheels or a senior volunteer from the local community. The program includes 6 visits over a 2 year period providing students an opportunity to apply their classroom education in the context and care of an older adult. Students practice and demonstrate basic clinical skills; including taking histories, interviewing, conducting examinations and cognitive assessments, and advising clients on nutrition, home safety, community resources and advance care planning.     

Educational objectives: 
  • Health professions students will develop competency with older adults;
  • Strengthen health care students clinical applications of medical education through an Interprofessional team experience in the SAGE Program;
  • Health professions students learn from each other and appreciate each others professions.
Publications from, presentations from, and/or citations to this product: 

SAGE Presentations

Marquez-Hall, S. (2015). Interprofessional practice: Seniors assisting in geriatric education. A round table presentation at the Interprofessional Practice Symposium, University of North Texas Health Science Center in Fort Worth, TX.

Marquez-Hall, S. Lane, Y. (2014) seniors assisting in geriatric education (SAGE): Reynolds program address the lack of training in geriatrics and provides a model for interprofessional education. Jefferson Center for Interprofessional Education Annual Conference, Jefferson Medical College, Philadelphia, PA.

SAGE Poster Presentations:

Marquez-Hall, S., Pitts-Lane, Y. Knebl, J., (2015). Seniors assisting in geriatric education (SAGE): Reynolds program addresses the lack of training in geriatrics and provides a model for interprofessional education. Poster presentation at Research Appreciation Day, University of North Texas Health Science Center, Fort Worth, TX.

Marquez-Hall, S., Lane, Y., Smith, R. (2014) Survey of medical students in a geriatric training program. Poster presentation at the American Geriatric Society Annual Scientific Meeting, Baltimore, MD.

SAGE Awards:

2013 Mae Cora Peterson Senior Spirit Award in recognition of the Seniors Assisting in Geriatrics Education (SAGE) Program, Senior Citizens of Tarrant County, Texas.

2011 AACOM Excellence in Communications Award. Second Place - Best Community Service Program-Serving Fewer Than 1,000. SAGE Program; University of North Texas Health Science Center at Fort Worth, Texas College of Osteopathic Medicine.  

Date posted: 
Thu, 10/13/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/13/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Geriatric Education and Training in Texas: Seniors Assisting in Geriatric Education - Interprofessional Team-Based Training, Assignments & Grading. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

MDTea Podcast

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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: 

The MDTea podcasts are a series of podcasts designed for health and social care staff caring for older patients. Each episode we present a single topic relevant to the whole MDT caring for older people. Examples include: comprehensive geriatric assessment, Delirium, continence management, acture stroke presentaiton, communication with patients with cognitive decline, frailty and diagnosing dementia. 

Episodes are around 30 minutes long and each episode comes with referenced show notes and a free infographic. They are mapped to the UK postgraduate curriculums.

 

Availiable at: www.thehearingaidpodcasts.org.uk or via itunes

Educational objectives: 

These are specific to each episode and can be found at the top of the show notes

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Contact Person/Corresponding Author:



Suggested Citation:
MDTea Podcast. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

Family Medicine Resident and Geriatric Fellow Longitudinal Home Visit Curriculum

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

With an aging population, the need to train primary care residents and geriatric fellows in home-based care continues to grow. A needs assessment of family medicine residents and geriatric fellows' attitudes and knowledge was performed to guide a novel, longitudinal home care curriculum based out of a Home-Based Primary Care practice within the Family Medicine Center.

Fellows are assigned a panel of two home visit patients from the Family Medicine Center's Home-Based Primary Care practice. Fellows follow these patients monthly and manage their care between visits.  In today’s rapidly changing clinical environment, primary care physicains and geriatricians must be adapt at analyzing systems and processes they work under and making changes to improve patient care. A new home visit program is a natural venue for a specific, achievable quality improvement intervention with support from faculty, the Home Based Primary Care practice team and the Family Medicine Center Patient and Family Advisory Council. 

The longitudinal family medicine resident curriculum is based on graded autonomy and focused objectives for each level with the ultimate goal of residents feeling empowered to include home visits in their future practice. After home visit sessions, residents complete personal, written reflections after each visit to optimize learning and retention, as well as for giving a venue for processing potentially challenging situations. Sample reflections are included. Third-year residents facilitate an interdisciplinary case conference to address various social determinants of health, home safety issues and medication concerns. By residency graduation, residents will complete 10-14 home visits. 

 
Educational objectives: 
  1. Describe challenges and opportunities unique to patient care in the home environment.  
  2. Review medication use and adherence while identifying medications that are no longer effective, are duplicative or carry greater burden than benefit.  Identify medications that you would recommend stopping and create a schedule for stopping these medications.
  3. Develop and implement a safety plan to make the patient’s home environment safer.
  4. Develop a personal plan to integrate home visits into your future practice.

Fellow-specific objectives:

  1. Develop, document and manage patient- and family-centered care plans related to patient’s health conditions and expected trajectory with emphasis on personal goals of care in collaboration with an interprofessional health care team and community service providers.
  2. Implement a process improvement as part of the Home Based Primary Care team.  

 

Date posted: 
Wed, 10/19/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/19/2016
Contact Person/Corresponding Author:



Suggested Citation:
Family Medicine Resident and Geriatric Fellow Longitudinal Home Visit Curriculum. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

IMPROVE Polypharmacy Clinic Resource Site

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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: 
3
Abstract: 

Polypharmacy and inappropriate prescribing are common among older adults. Polypharmacy is associated with a variety of adverse outcomes in older adults including falls, adverse drug events, hospitalization, mortality, and measures of function and cognition. The Initiative to Minimize Pharmaceutical Risk in Older Veterans (IMPROVE) is an interprofessional polypharmacy clinic within an academic patient-aligned care team at the VA Connecticut Center of Excellence in Primary Care Education. The clinic consists of a pre-clinic conference, shared medical appointment, individual visit, and team precepting. The team consist of a pharmacist, geriatrician, primary care provider, and health psychologist and involves medicine residents, nurse practitioner residents, pharmacy residents, and psychology residents. This website describes the clinic design and provides the resources and links helpful for starting an IMPROVE Polypharmacy Clinic including forms, short topic discussions in polypharmacy, and various other resources helpful for deprescribing.

Educational objectives: 

This website:

1.  Describes the IMPROVE Polypharmacy Clinic design

2.  Provides resources needed to implement an IMPROVE Polypharmacy Clinic

3.  Provides handouts for short topic discussions on various polypharmacy-related topics and deprescribing

Date posted: 
Thu, 10/13/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/13/2016
Contact Person/Corresponding Author:



Suggested Citation:
IMPROVE Polypharmacy Clinic Resource Site. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

Interprofessional Geriatric Education and Training in Texas: Fall Risk Education & Assessment

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

Each year, one in every three adults ages 65 or older falls and 2 million are treated in emergency departments for fall-related injuries. The risk of falling increases with each decade of life. The long-term consequences of fall injuries, such as hip fractures and traumatic brain injuries (TBI), can impact the health and independence of older adults. However, falls are not necessarily an inevitable part of aging. In fact, many falls can be prevented. All healthcare professionals can take actions to protect older adults.

The University of North Texas Health Science Center (UNTSHC) Reynolds Interprofessional Geriatric Education and Training in Texas (IGET-IT) Program has developed a Fall Risk Assessment and Education module as part of the Interprofessional Communication Improvement Modules (ICIM) Elder Safety series. The ICIM Elder Safety modules were created in collaboration with the National Board of Osteopathic Medical Examiners (NBOME) and are supported, in part, by a grant from the Donald W. Reynolds Foundation. The goal of the Elder Safety ICIMs is to provide innovative and sustainable programs to improve the ability of physicians to work with other health disciplines in teams to provide better care for geriatric patients. The care of older adults can be very complex and studies have shown that a team approach can be most effective in leading to quality outcomes.

Educational objectives: 

Upon completion of this activity, participants will be able to:

  • Describe risk factors associated with falls in older adults using a comprehensive fall risk assessment.
  • Identify examination components to assess for fall risk.
  • Describe how neurocognitive features can contribute to the risk of falls.
  • Identify four essential tests to assess neurocognitive features.
  • Describe how sensory factors impact the risk of falls.
  • Identify exams to assess sensory factors.
  • Identify the prescription, nonprescription, nutritional supplements, and food/drug interactions that are most frequently associated with an increased fall risk.
  • Discuss polypharmacy and its impact on fall risk.
  • Examine the evidence behind nutritional supplements that may help reduce fractures from falls.
Publications from, presentations from, and/or citations to this product: 

Gimpel, J., & Dowling, D.J. (2014, August). Watch Your Step: An Osteopathic Approach to Patient Fall Prevention and Intervention. Presented at the Pennsylvania Osteopathic Family Physicians Society Annual Convention, Hershey, PA.

Marquez Hall, S. (2016, May). Assessment Tool for Elder Safety on the Topics of Falls Risk and Elder Mistreatment. Presented at American Geriatrics Society Annual Scientific Meeting Education Product Showcase, Long Beach, CA.

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Product Viewing Instructions: 
Select your activities and add them to your cart. In the cart, click Proceed to Checkout. You will be prompted to create a new account or log in to your existing one. Once your account is created, you will be directed back to complete your registration.
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Geriatric Education and Training in Texas: Fall Risk Education & Assessment. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

Interdisciplinary Experience on ACE Unit

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

During a 2- or 4-week elective geriatric rotation for medical students and month-long required rotation for Family Medicine residents, learners spend time as part of the ACE Unit Interdisciplinary Safety Team. One to two half days are spent working alongside patient care aides, physical therapy, occupational therapy or nursing to be exposed to a typical day for each team member. The experience allows learners to see the unqiue ways each discipline addresses the safety and works to maintain function of vulnerable, hospitalized older adults. Learners also participate in interdisciplinary rounds with their designated team members. 

Afterward, learners complete a written, personal reflection on the experience. Reflective ability is an important skill for practicing physicians but is rarely taught or encouraged through medical school or residency training. Furthermore, reflection is an important step in cementing new learning. 

Attached is a sample of the 2-week curriculum, a list of resources used with learners and overall description of the ACE rotation. Samples of these reflections are also included. Please contact me if you would like more information on the overall structure of these rotations. 

 

 

Educational objectives: 

1. Describe and participate in roles filled by physical therapy, occupational therapy, nursing and patient care aides as part of an interdisciplinary safety team caring for vulnerable, hospitalized older adults. 

2. Reflect on the experience to apply to future practice as a clinician. 

Date posted: 
Fri, 10/21/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 10/21/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interdisciplinary Experience on ACE Unit. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

Geriatric Interprofessional Teaching Clinic (GITC)

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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: 
•Collaborative interprofessional practice and care are essential to the complex healthcare needs of a rapidly growing older adult population.
•Interprofessional collaboration (IPC) occurs when various health care practitioners, clients and/or caregivers work together to improve a client’s overall health.
•Teaching an IPC model continues to be a major gap in every health professionals’ education.
•To address this gap, the Geriatrics Interprofessional Teaching Clinic (GITC) at the University of Kansas Medical Center's Landon Center on Aging was created. It incorporates six professions: Students and faculty from  Physical Therapy, Medicine, Pharmacy, Social Welfare, Dietitics/Nutrition and Occupational Therapy.
•It is scheduled one half day a week with four patients scheduled on a "rolling" basis allowing for interprofessional teams of three to see patients in a staggered fashion. On average, each visit takes approximately 60-90 minutes.
•Logistically, students from 3 professions review the medical record together, discuss what they want to accomplish in the room, and how they will approach the patient encounter as a team. The students then see the patient and report back to the attending physician and other health professions faculty as a team. The assessment and plan for the patient is developed by the team.
•Team members are asked to define their roles by what the patient needs at that particular visit, starting with their own professional training and scope of practice, but then encouraged to allow themselves to participate in new ways. The interprofessional clinic faculty assist the learners by facilitating reflection on their clinical performance as individuals and as a team at the time of the clinic visit, incorporating their reflections into their next clinical encounter and through debriefing.
•To quantify interprofessional collaboration, evaluation tools are being piloted to assess for team dynamics, and surveys are sent out to each individual learner to assess for behavior and attitude changes. These are both done at the "beginning" and "end" of their GITC experience.
 
 
Educational objectives: 
•Create an interprofessional (IP) clinic involving multiple learners, emphasizing the national interprofessional competencies (values/ethics, roles/responsibilities, interprofessional communication and teams/teamwork).
•Train students in IP teams to evaluate their communication with the patient and with other team members following a patient encounter in GITC using a validated rubric. 
•Monitor changes in IP team behavior through individual learner evaluations.
Date posted: 
Mon, 10/10/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/10/2016
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Interprofessional Teaching Clinic (GITC). POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

Elder Care A Resource for Interprofessional Providers: Recognition of Advanced Illness and Impending Death

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

Recognition of Advanced Illness and Impending Death 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. Discuss prognosis of a fatal illness with patients and their families.
  2. Recognize signs and symptoms of imminent death
  3. Communicate effectively with families of patients who are demonstrating signs and symptoms of imminent death
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 Geriatrics Workforce Enhancement Program”. 
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: 
Fri, 09/02/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 09/02/2016
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Recognition of Advanced Illness and Impending Death. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/1093

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