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JAMDA
March 1, 2016

Hospitals and skilled nursing facilities (SNF) face growing financial pressure to decrease readmission rates. Transitional care has proven effective for patients with chronic conditions across healthcare settings, typically from the hospital to home or from the hospital to SNF. However, it is rarely implemented when transitioning a patient from SNF to home. Many of these patients are placed in SNF after hospital discharge because of significant co-morbid conditions that place them at high risk for readmission, and many of the factors causing the risk are still present at discharge from SNF...

JAMDA
March 1, 2016

In 2012, ∼25% of skilled nursing center residents nationwide were prescribed antipsychotics, despite a 2005 Federal Drug Administration “black box” alert warning that these medications may increase residents' risk of heart failure, sudden death, and pneumonia. Although experts agree that non-pharmacologic measures (such as environmental modifications) are preferable to medications, there is little guidance about what staff should do in lieu of prescribing medications. As a result, Maine nursing center leaders developed the Curtailing Antipsychotic Medications in LTC Medicine (CALM)...

JAMDA
March 1, 2016

Patients receive medical care in a variety of settings including long-term care (LTC) nursing facilities, assisted living facilities, transitional care facilities, and private homes. The number of patients who require skilled nursing care either at home or in a LTC facility will increase in the coming years as the number of older adults and the complexity of their medical conditions increases. Clinicians who care for these patients outside of the clinic often lack standard medical equipment and supplies, which can lead to significant interruptions in patient care or incomplete care...

JAMDA
March 1, 2016

National antipsychotic use in the long-stay residents has declined to 19% now. Efforts are underway to reduce this rate even further. In specialized dementia units, however, where patients with BPSD are concentrated, medication use rates are expected to be much higher. Additionally, other psychotropic medications are often utilized in the management of BPSD. There is scarcity of data regarding the use of all psychotropic medications and regarding prevalence of medication use and outcomes in specialized dementia units setting.

JAMDA
March 1, 2016

Reducing polypharmacy is a priority of CMS and AMDA. The Indiana State Department of Health (ISDH) has approved a collaborative proposal that will build an innovative infrastructure of quality improvement (QI) and formally engage nursing home physicians and medical directors through IMDA, Indiana Society of Post-Acute and Long-Term Care Medicine (IMDA), to address polypharmacy.

JAMDA
March 1, 2016

Amiodarone is a potent antiarrhythmic which is effective for maintaining sinus rhythm but with potentially disabling side effects. There are well known black-box warnings associated with its continued use: sudden death and deadly side effects including pulmonary toxicity, hepatotoxicity and proarrhythmia. The North American Society of Pacing and Electrophysiology (NASPE) have specific guidelines for its continued usage. Residents in our 720 bed post-acute and long-term care facility are admitted and maintained on this agent but there is no data about how well they are monitored.

JAMDA
March 1, 2016

Teaching family practice resident physicians to perform a quality transition of care upon hospital discharge is an important and common skill. It is an area of medicine that has been shown in studies to be prone to communication and medical errors which affect patient care and can lead to readmissions. Within our own residency, a need to improve our curriculum was identified. It was decided to integrate an interprofessional team approach and home visits into this educational experience.

JAMDA
March 1, 2016

In recent years, the SNF/LTC Industry has seen the demand for its services increase. This has been due in part to a shift in population demographics as well as to financial incentives for hospitals to reduce patient stays. This is driving the need for more doctors with the skills necessary to care for the elderly in the SNF environment. Being part of a small medical community with a newly established family medicine residency program, we have elected to partner with our local SNF's to engender within our Family Medicine Residents an understanding for SNF/LTC care and the need for...

JAMDA
March 1, 2016

In anticipation of the changes required of our health care system to support a growing population of older adults, a geriatric pharmacy initiative designed to foster interest in geriatrics and long term care (LTC) as well as inter-professional collaboration was introduced at the Barrie Royal Victoria Regional Health Centre (RVH) Family Medicine Residency Program. The initiative involved a pharmacist-led half-day practicum in a LTC home and pharmacy with the goal of creating a positive work experience that would nurture a passion for geriatric medicine in upcoming physicians as well...

JAMDA
March 1, 2016

The objective for this study is to assess our physicians in training competency with regard to communicating with older patients. We present needs assessment survey results, curriculum development, and proposed implementation.