Geriatric

Geriatric / en Sat, 26 Apr 2025 00:02:23 -0500 Tue, 21 Jan 25 10:28:20 -0600 Butler Hospital leads research, education and community outreach on Alzheimer’s /role-hospitals-butler-hospital-leads-research-education-and-community-outreach-alzheimers <div class="container"><div class="row"><div class="col-md-9"><div class="col-md-6"><img src="/sites/default/files/2025-01/THS-butler-alzheimers-research-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Butler Hospital in Providence, R.I., is leading research studies on prevention, diagnosis and treatment of Alzheimer's disease and related dementia through its multifaceted Memory and Aging Program (MAP)." width="700" height="532"></div>Butler Hospital in Providence, R.I., is leading research studies on prevention, diagnosis and treatment of Alzheimer's disease and related dementia through its multifaceted Memory and Aging Program (MAP). It’s an urgent health concern as Alzheimer’s currently has no cure.Nearly 7 million people in America are living with Alzheimer’s, the most common cause of dementia. Though the disease is not a normal part of aging, the greatest known risk factor is increasing age. It’s estimated that 1 in 3 adults over age 65 dies with Alzheimer’s or another dementia, according to the <a href="https://www.alz.org/alzheimers-dementia/what-is-alzheimers" target="_blank">Alzheimer’s Association</a>.Part of MAP at Butler Hospital is a prevention registry for people with normal memory or mild memory loss interested in participating in a research study or clinical trial. Several active studies on preventing and treating Alzheimer’s are open for enrollment, led by MAP’s team of neurologists, neuropsychologists, research and clinical nurses, interns and post-doctoral fellows, and research assistants.In addition, MAP is expanding its Spanish-language outreach initiatives. Hispanic people are 1.5 times more likely to develop Alzheimer's compared to non-Hispanic white individuals. MAP partners with local health clinics and community centers to offer memory screenings, educational programs on brain health and aging, and research opportunities to historically marginalized communities. Presentations and information are offered in English and Spanish.To further increase outreach, MAP recently implemented an advance translation system that offers a wider range of languages and improved translations.Learn more about <a href="https://www.butler.org" target="_blank">MAP</a> and its <a href="https://www.butler.org/memoryandaging/beyond-translation-the-memory-and-aging-programs-culturally-tailored-approach-to-raising-alzheimers-awareness-in-the-hispanic-community" target="_blank">community outreach efforts</a>.</div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/innovation">Innovation, Research and Quality Improvement</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Tue, 21 Jan 2025 10:28:20 -0600 Geriatric AHA podcast: Preparing for the Future — How the Age-Friendly Health Systems Initiative Is Transforming Care for America's Aging Population /news/headline/2024-12-02-aha-podcast-preparing-future-how-age-friendly-health-systems-initiative-transforming-care-americas In this conversation, Dave Eaker, geriatric program manager at Atrium Health, and Shannon Morton, assistant vice president of patient care services at Atrium Health Cabarrus, discuss the reasons the organization joined the Age-Friendly Health Systems Initiative, the infrastructure being developed across the system and the difference it has made for the aging population. <a href="/advancing-health-podcast/2024-12-02-preparing-future-how-age-friendly-health-systems-initiative-transforming-care-americas">LISTEN NOW</a> &nbsp;<div></div> Mon, 02 Dec 2024 15:50:41 -0600 Geriatric The Work of Action Communities in Age-Friendly Health Systems /advancing-health-podcast/2024-09-23-work-action-communities-age-friendly-health-systems Since 1982, The John A. Hartford Foundation has been a national leader in&nbsp;raising awareness and improving health care for older adults. In this conversation,&nbsp;Rani Snyder, vice president, Program at The John A. Hartford Foundation, discusses the importance of Action Communities in age-friendly care, and why health organizations should use the tools they provide to build exceptional care frameworks.<hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript &nbsp; </h2> </summary> 00:00:00:12 - 00:00:35:01 Tom Haederle Just six years from now, by 2030, the Census Bureau projects that people age 65 and older will account for more than one fifth of the U.S. population. This game-changing statistic is driving society to rethink how it responds to the health concerns and needs of so many older adults. Fortunately, a movement across the country and spreading globally, known as age-friendly health systems, is here to help. 00:00:35:03 - 00:01:14:08 Tom Haederle Welcome to Advancing Health, the podcast from the �� Association. I'm Tom Haederle with AHA communications. Since the early 1980s, the John A. Hartford Foundation has been a national leader in improving health care for older adults. AHA has been a key partner in the movement. In today's podcast, Raahat Ansari, senior program manager for population health with AHA, is speaking with Rani Snyder, a vice president with the Foundation, to explore why health organizations of every type should consider participating in an action community and integrating the evidence-based principles of age-friendly health systems into their own care networks. 00:01:14:11 - 00:01:28:27 Raahat Ansari Thank you so much for being here with us today, Rani, and having worked with you and the John A. Hartford Foundation for many years, I would love for you to tell our listeners today a little bit about the vision and how this work got started. 00:01:28:29 - 00:02:03:17 Rani E. Snyder I would love to do that. Thank you, Raahat. The John A. Hartford Foundation has a very long history in funding in aging. So, we started our work specific to aging in health in 1982, which, if you think about it, means 42 years of funding specific to aging. So much of that work started with building geriatrics expertise in medicine and nursing and social work, interdisciplinary team care and ultimately also in a variety of models of care. 00:02:03:19 - 00:02:24:09 Rani E. Snyder Our current president, Terry Fulmer, came in about nine years ago. She brought me in shortly thereafter as the vice president for program, and she was really charged to move the needle. We built all this expertise, all these fantastic innovations, and they weren't spreading the way we really wanted to see them spread for the growing number of older adults in our country. 00:02:24:11 - 00:02:28:07 Raahat Ansari Interesting. We know there's a lot of work that needs to be done, but not enough happening to make it move. 00:02:28:09 - 00:02:49:28 Rani E. Snyder That's exactly right. So there was sort of a frustration on our part, because we had been in the field for all those years. You know, we celebrate longevity apparently also in our funding. There's a frustration with that know-do gap that exists when it comes to the best possible care for older people. So, we understood at that point that we needed to determine how to go big. 00:02:50:01 - 00:03:15:25 Rani E. Snyder We understood that the way to do that is to build on collaboration and partnerships. And so we partnered with the Institute for Health Care Improvement. We partnered with the �� Association and health systems themselves, in addition to the creators, the real leaders, of creating those evidence-based models and innovations to come up with what we now call age-friendly health systems. 00:03:15:27 - 00:03:40:11 Raahat Ansari Thank you. That is so amazing to hear, and it's always rejuvenating to hear how this work started and the importance of it, because we all know that this work is just so important. And, you know, one little anecdote that I'll just share is hearing from people participating in our action communities. Everybody knows someone who's getting older. Everyone cares about someone who's getting older and is getting older themselves. 00:03:40:14 - 00:04:00:01 Raahat Ansari So I think that's one other really big driver of this work that people will find a real connection to it. So, with that being said, the AHA has an Action Community coming up in September, and we're looking for folks to join us in that seven-month-long virtual Action Community. But I'd love to hear from you. Tell us, what's the selling point? 00:04:00:01 - 00:04:05:15 Raahat Ansari Why should an organization participate in the Action Community? What's the opportunity for them there? 00:04:05:21 - 00:04:28:00 Rani E. Snyder Absolutely. And I'm going to start by stepping a little, a half step back to say what an Action Community is. So, an Action Community is a seven-month process by which a health system can learn how to implement age-friendly health systems care in their system, in any given site of care, whether it's a hospital or clinic or a nursing home. 00:04:28:02 - 00:04:35:22 Rani E. Snyder So, we sometimes get a laugh out of the fact that it's free. The Action Community is free to join the community, but guess what? It's not really free. 00:04:35:22 - 00:04:36:21 Raahat Ansari That's so true. 00:04:36:24 - 00:04:54:24 Rani E. Snyder It's underwritten by the John A. Hartford Foundation, because we feel so passionately that this kind of care that is best care, best evidence-based care for older adults at any site of care, from the kitchen table to anywhere they go for their care and then back home again, wherever home may be, that we are willing to underwrite the cost. 00:04:54:25 - 00:05:17:01 Rani E. Snyder So, I would say to any health system that is considering the increasing number of older adults and some of the difficulties that come with best care for people who have oftentimes multiple and chronic complex needs. Don't leave that money on the table. We're putting it up, so they should really take advantage of this opportunity. And that's just one of the reasons; there are a whole host of reasons. 00:05:17:01 - 00:05:38:06 Rani E. Snyder Some of the others include the fact that there's really powerful peer-to-peer learning in the action communities, because there are teams from other sites of care and other health systems all across the country that sign up for an Action Community. There often are over 100 different individual units, team units, that are doing this work, and that's really cool. 00:05:38:07 - 00:05:51:22 Rani E. Snyder Also, there are a variety of other things that come with it. So, for example, there's coaching support along the way from, in this case, the �� Association. But there are also Action Communities that are put on by the Institute for Health Care Improvement. 00:05:51:23 - 00:05:51:24 Raahat Ansari That's right. 00:05:51:25 - 00:05:52:12 Rani E. Snyder And others. 00:05:52:12 - 00:05:53:26 Raahat Ansari State-based ones. 00:05:54:03 - 00:06:07:20 Rani E. Snyder Absolutely. So, there are a lot of ways to go about it. And we, the John A. Hartford Foundation, don't particularly care where you join as long as you do. It's just that the AHA Action Community that's coming up is perfect timing. 00:06:07:21 - 00:06:09:24 Raahat Ansari Exactly. It's all about the timing. 00:06:09:25 - 00:06:30:08 Rani E. Snyder Absolutely, absolutely. The upcoming Action Community for AHA starts in September. So, the other thing I want to reference, though, with regard to why would you want to join an Action Community, why would you want to participate in age-friendly health care and the movement that it has become? It really comes down to outcomes, and this is what is really important to so many hospitals. 00:06:30:08 - 00:06:36:29 Rani E. Snyder So, I'm going to speak across the board instead of citing a particular either site of care or health system. 00:06:37:00 - 00:06:43:24 Raahat Ansari I'm sure that's impossible to do because there's so many hospitals that have such good outcomes. But yes, we'd love to hear a general, a general sense. 00:06:43:24 - 00:06:54:23 Rani E. Snyder You are 100% right. 100% right. So, some of the kinds of outcomes we are hearing about are decreased length of stay. Do these sound like things that hospitals care about, decreased readmissions? 00:06:54:23 - 00:06:55:05 Raahat Ansari Right. 00:06:55:07 - 00:07:04:21 Rani E. Snyder The other one that's really interesting, and this is a little more anecdotal than some of the studies I've seen in individual sites, is we keep hearing of increased workforce satisfaction. 00:07:04:28 - 00:07:14:03 Raahat Ansari That's amazing because it's so important right now to the field in terms of retention and safety and just being healthy, and especially with Covid and the long hours. That is amazing. 00:07:14:03 - 00:07:40:18 Rani E. Snyder That's a winner right there. And we know it's something that hospitals and health systems everywhere are really aware of, really conscious and working on. And then there's this one really cool example of a health system that studied as a part of determining what the outcomes have been of their age-friendly health systems work, studied time given back to patients and families, in not having to go to extra appointments and not having to go for the readmissions, those kinds of things. 00:07:40:21 - 00:07:54:19 Raahat Ansari Oh, that is so powerful. And that just gets back to the Òwhat mattersÓ of this, right? As a part of one of the 4Ms, how do you want to spend your time and what matters to you and that that is so huge that you've got some time back to do the things that you love. 00:07:54:24 - 00:08:10:24 Rani E. Snyder Exactly. And to speak in sort of hospital parlance, you know, it's back to patient satisfaction. And that also matters very much to the, maybe not the bottom line; well, maybe the bottom line, but certainly to the reputational and other sort of assets of any health system organization. 00:08:10:27 - 00:08:30:18 Raahat Ansari That's right. That's amazing. So, with the age-friendly health systems work, we at the AHA have been doing this for a little while now. And the AHA has released a new initiative called the Patient Safety Initiative. And as a part of that, we're learning that we can expand this, and we can bring in folks from all levels of the hospital leadership. 00:08:30:18 - 00:08:54:27 Raahat Ansari And so, the one new area that we're looking into is including the board members. And how are you bringing them into the conversation? How are you leveraging their expertise and what they bring to the table? How are you leveraging that to advance the work of age-friendly within your organization? So, I know that you, congratulations, have recently become a committee member of the Mid Coast Hospital, which is part of MaineHealth, the elder and home care committee. 00:08:55:01 - 00:09:09:10 Raahat Ansari So, I know that you've been recently appointed to that. Can you tell us a little bit about what your plan is and what you would recommend other trustees to do to ensure that their hospital and health system is bringing age-friendly care to their organization? 00:09:09:12 - 00:09:31:01 Rani E. Snyder Absolutely. So, this is a hospital in my hometown, in my home state in Maine, Brunswick, Maine. And so I've joined this committee. And I think that it's really important as we're thinking about the numbers of older adults and the ways that we are serving them to ask the questions that both speak to the needs of a hospital or a health system. 00:09:31:01 - 00:09:52:25 Rani E. Snyder And that comes down again to things like lowering costs, improving safety, improving quality and that also serve the patients. So, I'm actually feel really fortunate because the committee I just joined, the elder and home care committee, has even before I came, decided to take on age-friendly, health-systems-based care for their nursing home, and they were in the process of doing that work. 00:09:52:26 - 00:09:53:25 Raahat Ansari Perfect timing. All about timing, right? 00:09:53:25 - 00:10:21:21 Rani E. Snyder Exactly, exactly. So, I don't even have to push it. But I can ask the kinds of questions that raise these issues so that hospitals and health systems and fellow board members are aware that these resources are out there. I mean, if we're talking about hospitals, we're talking about age-friendly health systems, as well as some of the other initiatives that our foundation supports and that are very complementary and integrated with age-friendly health systems like geriatric ED care. 00:10:21:21 - 00:10:49:12 Rani E. Snyder So, through the American College of Emergency Physicians and their accreditation for geriatrics EDs, or the American College of Surgeons Geriatric Surgery verification, which is another hospital-based program. So, if you're asking the kinds of questions that indicate that you're both looking at the bottom line, looking out for the hospital, but quite frankly aware of and understanding and pushing the importance of caring for the older people in that health system, you're basically it's a win-win or a win-win-win, It's a lot of wins. 00:10:55:00 - 00:11:14:24 Raahat Ansari Right, everybody wins. And I think that's a fantastic answer. And in that answer, I actually think I heard a little bit about the last point that I want to take to make sure that we touch on. And again, we've been working together for many years now. And when we started this work, we were really focused on the inpatient setting, which made sense, and we had a lot of impact there. 00:11:14:26 - 00:11:21:09 Raahat Ansari And I would just love for you to talk a little bit about how far we've come and the work that we still have left to do. 00:11:21:11 - 00:11:45:25 Rani E. Snyder Absolutely. And I really want to give credit here to our president, Terry Fulmer. This is very much her baby. I will say I was there at the very first meeting, but I am not the driver on this one. It's been so exciting to see that the ways that this work has taken off, the fact that the 4Ms of best evidence-based care for older adults is something that really has a lot of traction with both clinicians and the public. 00:11:45:25 - 00:11:59:10 Rani E. Snyder People understand what it means to ask, assess and track what matters to older people, to pay attention to medications, to focus on mobility as a measure of essentially function. 00:11:59:14 - 00:12:10:20 Raahat Ansari Sure. Isn't it so interesting how it just like, pulls everyone, to get like anybody, like you just said, that a provider or a patient, anybody can just easily latch onto it. It's super simple, I love that. But yes, please continue. 00:12:10:20 - 00:12:34:01 Rani E. Snyder Absolutely. Well, and the only one left that I haven't mentioned yet, is mentation, which is anything of the mind. You know, if you were a geriatrician, you'd be thinking of the 3Ds: dementia, delirium, depression, right? But really, it's anything cognitive. So, we started out our full group together with IHI and AHA and the others, started out thinking about it as a hospital-based possibility but very quickly realized that that was necessary but insufficient. 00:12:34:06 - 00:12:34:22 Raahat Ansari Correct. Yeah. 00:12:34:22 - 00:13:00:09 Rani E. Snyder And that older people get care that either helps or frankly can harm them in a whole host of settings. So, we, a couple of things have changed over the almost nine years, I'd say eight or nine years of this work. First of all, we just started a new expansion of the work that is systemwide. So up until now, through the Action Communities, a particular site of care might join. 00:13:00:09 - 00:13:24:07 Rani E. Snyder It might be a hospital unit, it might be an ambulatory clinic, it might be a nursing home, as I mentioned. And those sites are a single site. But what we're doing now is working with 30 systems that have volunteered, that have signed up because they see and feel the importance of this and have seen, quite frankly, some of the positive outcomes, to push it across all of the different settings ultimately in their systems. It's super exciting. 00:13:27:08 - 00:13:59:00 Raahat Ansari Yeah, and that's really interesting. And I think that's like one other key point for those who might not have participated in the age-friendly work to date is that this framework fits in any unit, and even being in a single organization, it could mean something very different based on from one unit to the next. And that's the whole point of this framework, is that it can be tailored to fit the needs of the unit in the organization, whether the type of setting you're in, you know, you had spoken about the hospital that you're working with is a little bit of a rural in a rural area. 00:13:59:00 - 00:14:14:12 Raahat Ansari You know, we also have critical access hospitals and, you know, within the rural areas, of course, and academic medical centers. So just this is literally tailored. You can tailor this to fit any care setting. So, and I think, you know, you mentioned that it's in the convenient care clinics. The CVS. 00:14:14:14 - 00:14:38:05 Rani E. Snyder Yes. Absolutely. Well so we're now moving to spread through all parts of the health system. So, we started with age-friendly health systems, with the geri-ED work that I mentioned and the surgery work, the geriatric surgery verification. Well, now we're talking about, as you mentioned, CVS minute clinics, all of the minute clinics in the country have been in the process for several years now of becoming age-friendly, which is super exciting. 00:14:38:05 - 00:14:59:06 Rani E. Snyder In addition, I mentioned nursing homes and ambulatory care settings. PACE sites. So, for folks who are not familiar with what PACE is, it's an acronym that stands for Programs of All-Inclusive Care of the Elderly. Really, it's everywhere. And in fact, there are crosswalks to some of the community-based organizations that are doing work in partnership now with health systems as well. 00:15:01:10 - 00:15:19:28 Raahat Ansari That is so amazing. And we could talk for hours, but I know we're at time. So just wanted to thank you one last time and pause to say if there are any other comments that you wanted to just give to our Action Community, people are thinking about joining or people who are well on their path, anything you additional you might want to share. 00:15:20:01 - 00:15:42:10 Rani E. Snyder I would love to. There are some other expansion areas that I didn't mention, so that includes things like age-friendly health systems for caregivers. So, caregivers are themselves a twofer, right? Because it's their health impacts not only themselves but also the person they're caring for. So, this is not just about the care recipient, but the person who's doing the work for them. 00:15:42:10 - 00:16:05:01 Rani E. Snyder And really working that in. The Veterans Administration is doing this work across the country. So, we're very excited about that. And we're really thinking through and implementing age-friendly care in home-based primary care. This is care for people who can't get out of their home to go to a primary care clinician of some sort. Hospital at home. 00:16:05:01 - 00:16:38:17 Rani E. Snyder So back to the hospital. But really thinking about that kind of hospital-level care at home for those people where it's appropriate, and many, many others are joining the movement. So, the last thing that I guess I'll say is that there are other funders, who have, who are increasingly joining this work as well. So, depending on where a health system is, there may be funders in your community that will help you to not just join an Action Community because we fund those, but to really implement the principles of age-friendly care, to measure the age-friendly care that they're implementing. 00:16:38:18 - 00:16:53:17 Raahat Ansari That's huge. So that data, right, not only helps the organization itself, it can help other teams that are looking, then thinking about it, to build that case and bring that back to their own organization. So, there's so much data out there. Be sure to look for it on all of our websites. 00:16:53:17 - 00:17:13:12 Rani E. Snyder You bet. Thank you. We're doing some work with UCSF to be sort of the national clearinghouse of some of that work, and to lead some of the evaluation and outcomes on the age-friendly health systems work. So, we invite everybody to join us. All we want, really, is to make sure that every older adult, everywhere they are, gets the best possible care. 00:17:13:19 - 00:17:16:14 Raahat Ansari I love that. Thank you. Thanks for being here with us today. 00:17:16:15 - 00:17:17:24 Rani E. Snyder My pleasure. 00:17:17:27 - 00:17:26:08 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts. </details> </div> Mon, 23 Sep 2024 08:23:27 -0500 Geriatric For A-fib Patients, a Life Without Blood Thinners /role-hospitals-medical-university-south-carolina-fib-patients-life-without-blood-thinners <div class="container"><div class="row"><div class="col-md-9"><div class="col-md-5"><img src="/sites/default/files/2024-09/ths-musc-watchman-700x532.jpg" data-entity-uuid data-entity-type="file" alt="MUSC. A female doctor listens to an older male patients heart." width="700" height="532"></div>For years, the first-line treatment for atrial fibrillation, or A-fib, has been blood thinners. A-fib, which is a cardiac rhythm abnormality, can lead to other health complications, including strokes — it’s estimated that 90% of all strokes happen in patients who have A-fib.The problem with blood thinners is exactly what makes them so effective: They prevent blood clots. This is good when trying to avoid a stroke, but can cause complications when A-fib patients undergo surgery, fall, or have a history of other bleeding problems.The WATCHMAN device solves that issue. It’s essentially a small plug placed on the left atrial appendage that prevents blood clots from forming there and traveling to the brain. It’s a simple solution. L. Garrison Morgan, M.D., director of the Structural Heart Disease program at the Medical University of South Carolina, says that his team can implant the device in about 15 minutes. The patients are on bed rest for about two hours, and then they go home. In the past six years, MUSC patients have experienced a 99.5% success rate and zero major complications. How did Morgan’s team get so good? In August, they completed their 800th WATCHMAN procedure.But it’s no longer just a matter of volume. “There are clinical trials that we were part of that are essentially giving patients the option of having a WATCHMAN device as a first-line therapy,” Morgan said, which would mean that A-fib patients would never have to go on blood thinners for their condition.” “It’s very safe. It’s effective. It’s quick. And it gives the patient a lifetime’s worth of stroke prevention from one simple procedure.” <a href="https://web.musc.edu/about/news-center/2024/08/22/musc-health-columbia-medical-center-downtown-helps-hundreds-get-off-blood-thinners-with-watchman">Read more about MUSC and WATCHMAN here</a>.</div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/innovation">Innovation, Research and Quality Improvement</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 19 Sep 2024 19:13:46 -0500 Geriatric CMS launches model aimed at improving dementia care /news/headline/2024-07-08-cms-launches-model-aimed-improving-dementia-care The Centers for Medicare &amp; Medicaid Services July 8 announced over 400 participants in a new model focused on improving dementia care. The <a href="https://www.cms.gov/priorities/innovation/innovation-models/guide">Guiding an Improved Dementia Experience (GUIDE) Model</a> began July 1 and seeks to reduce strain on unpaid caregivers as well as offer care coordination and management, caregiver education and support, and respite services. CMS will also test an alternative payment for participants delivering key support services to people with dementia, including comprehensive, person-centered assessments and care plans, care coordination, and 24/7 access to a support line. People with dementia and their caregivers will have access to a care navigator to help them access services and support, including clinical services and non-clinical services such as meals and transportation through community-based organizations. Mon, 08 Jul 2024 16:02:43 -0500 Geriatric AHA podcast: Caregivers Need Care, Too /news/headline/2024-05-29-aha-podcast-caregivers-need-care-too As Americans age, health care is seeing a shift in addressing the unique needs of older adults, but what about those caring for their loved ones? Diane Mariani, program manager at Rush University Medical Center, discusses their Caring for Caregivers program, which shares resources and guidance to family and friends who care for older adults, while helping them better manage their own health and wellness. <a href="https://www.youtube.com/watch?v=lRIIvSuEmMc">WATCH NOW</a> Wed, 29 May 2024 14:39:11 -0500 Geriatric AHA podcast: Providing Behavioral Health Support for Older Adults /news/headline/2024-05-22-aha-podcast-providing-behavioral-health-support-older-adults Behavioral health conditions among older populations are often underrecognized, undertreated and stigmatized, according to the World Health Organization. Learn how West Virginia’s Broaddus Hospital works to identify and meet the unique mental health needs of their older community members with Senior Life Solutions, its intensive outpatient group therapy program designed for patients 65 and older. <a href="/advancing-health-podcast/2024-05-22-providing-behavioral-health-support-older-adults">LISTEN NOW&nbsp;</a> Wed, 22 May 2024 14:35:11 -0500 Geriatric Providing Behavioral Health Support for Older Adults /advancing-health-podcast/2024-05-22-providing-behavioral-health-support-older-adults According to the World Health Organization, behavioral health conditions among older populations are often underrecognized, undertreated and stigmatized. Broaddus Hospital, a critical access hospital and part of Davis Health System, tackled this problem head-on with the development of Senior Life Solutions, an intensive outpatient group therapy program designed for patients 65 and older. In this conversation, Broaddus Hospital's Dana Gould, CEO, and Donetta McVicker, program director of Senior Life Solutions, share how they are working to identify and fill the unique mental health needs of their older community members.&nbsp;<hr><div></div><div class="raw-html-embed"><details class="transcript"><summary> <h2 title="Click here to open/close the transcript.">View Transcript &nbsp;</h2> </summary> 00;00;00;17 - 00;00;35;07 Tom Haederle According to the World Health Organization, behavioral health conditions among older people are often under-recognized and undertreated, and the stigma surrounding these conditions can make people hesitant to seek help when they need it. West Virginia based Broaddus Hospital, a critical access hospital that is part of the Davis Health System, has created Senior Life Solutions, an intensive outpatient program designed to fit the needs of patients 65 and older. 00;00;35;10 - 00;01;10;10 Tom Haederle Welcome to Advancing Health, a podcast from the �� Association. I'm Tom Haederle with AHA communications. Although the overall population of Broaddus Hospital's rural community has decreased over time, the population of older adults has steadily increased. What wasn't increasing, however, was the availability of behavioral health services for this population. Recognizing that there were many older community members who needed help managing depression, anxiety, social isolation and grief, the team at Broaddus Hospital decided to get to work to create a treatment program that address their unique needs. 00;01;10;13 - 00;01;33;24 Tom Haederle In this podcast, hosted by Jordan Steiger, senior program manager of Clinical Affairs and Workforce with the AHA, she is joined by two leaders who share how this hospital-based program has benefited not only patients who seek care through their program, but the community overall. Dana Gould is CEO, Broaddus Hospital, and Donetta McVicker is program director of Senior Life Solutions with Broaddus Hospital. 00;01;33;27 - 00;01;45;09 Jordan Steiger Dana and Donetta, thank you so much for being with us today on our AHA Advancing Health podcast. We're really excited to talk to you today and to hear your perspective about some of the work that you've been doing. 00;01;45;12 - 00;01;46;19 Dana Gould Thank you for having us. 00;01;46;21 - 00;01;52;04 Jordan Steiger So tell us a little bit about Broaddus Hospital and the community that your hospital is in. 00;01;52;06 - 00;02;12;08 Dana Gould It's a critical access hospital, 72 bed facility. We have 12 acute care swing beds as well as a 60 bed nursing home. We're located in Philippi, West Virginia, a pretty rural area. And so this is a nice facility to have here in our small community. 00;02;12;10 - 00;02;21;14 Jordan Steiger It's great. And you know, how many communities does your hospital serve? Is it just in your town or does it kind of serve a bigger, rural population? 00;02;21;16 - 00;02;30;27 Dana Gould We serve our surrounding counties there, about five different surrounding counties that we serve, in addition to Barbara County, West Virginia. 00;02;31;00 - 00;02;53;22 Jordan Steiger You know, that's really nice to hear. And I think something that other, you know, rural listeners can resonate with, you know, serving that big population, that big, area, you know, in your community and not just the people that may be live next door to you, but also the people that kind of live just in your region. And, we know that a lot of communities really depend on the work of rural and critical access hospitals to get care. 00;02;53;22 - 00;03;07;00 Jordan Steiger So, we're really excited to learn more today. What are some of the common, you know, kind of like population health issues that face your community, especially related to behavioral health and substance use? 00;03;07;02 - 00;03;29;11 Dana Gould Well, we do our annual community &nbsp;- not annual, and we do it every three years - our community health needs assessment. And so for the last several years when we've completed that, we've found that behavioral health is one of the areas of greatest need in our community. We also have a pretty large percentage, around 20 some to 22% of population 00;03;29;11 - 00;03;49;25 Dana Gould that's over 65 years of age. And we're finding that even though the population of our county has decreased or remained relatively flat, the population of those 60 and 65 or older, have has increased. So, there is of an increasing need for behavioral health in our community. 00;03;49;27 - 00;04;16;29 Jordan Steiger I think that leads us into exactly what we're here to talk about today. So, your hospital has a really strong, geriatric, intensive outpatient program. And I think that's really unique and something that our listeners are going to be really interested in just because, as you mentioned, a lot of communities I think, are kind of facing that same issue of aging populations and maybe not having enough care in the area to help them with their behavioral health issues. 00;04;17;02 - 00;04;28;27 Jordan Steiger And it sounds like what you've done has really enhance the quality of life for the older adults and their families in your community. So I'd love if you could tell us a little bit more just about your program. 00;04;29;00 - 00;05;00;12 Donetta McVicker Okay, I guess I will step in there. My name is Donetta McVicker. I am the program director here at Senior Life Solutions at Broaddus Hospital. Senior Life Solutions is an outpatient behavioral health program here at Broaddus Hospital. It's designed to meet the unique needs of older adults, typically 65 and older, who are experiencing issues such as depression, anxiety, or other mental health challenges associated with the changes that accompany the aging process. 00;05;00;14 - 00;05;08;00 Donetta McVicker Our services include group therapy, individual therapy, family therapy, and medication management. 00;05;08;02 - 00;05;16;02 Jordan Steiger That's great. Can you tell us more about maybe some of the skills that patients learn? Maybe in group therapy or individual therapy? 00;05;16;04 - 00;05;53;14 Donetta McVicker Yeah, absolutely. Our therapy sessions occur in small groups and are facilitated by our licensed therapist. Patients typically attend group sessions three days a week, at first, and then they titrate to two or one day per week as they progress through the program. The program usually uses various skills to support patients in achieving their personal therapy goals, such as mindfulness, grounding skills, progressive muscle relaxation, self-care, social and communication skills. 00;05;53;16 - 00;06;18;01 Jordan Steiger That's great. And you know, I know, one thing that we talked about when I initially learned about your program is that you've seen maybe that there's been an increase in, you know, socialization of the older adults in your community from meeting each other in this program. And can you talk about maybe some of kind of the positive byproducts that have come out of having this kind of group therapy setting? 00;06;18;04 - 00;06;49;19 Donetta McVicker Our patients typically experience a lot of isolation and loneliness. So once they engage in the program, they meet new people who are experiencing similar issues that they are currently experiencing themselves. So they relate with one another, and they become friends. A lot of times, once they're discharged, they still remain in contact with the people that they met in group. 00;06;49;21 - 00;07;12;19 Donetta McVicker They've created these relationships with the other clients, and they will call each other on the weekends, or they'll arrange an outing and have coffee together or something like that. And that really increases their socialization and, really improves, some of their mental health issues. 00;07;12;21 - 00;07;33;13 Jordan Steiger I think that is an incredible thing to highlight here because obviously, you know, we're looking for in a program like this, you know, positive clinical outcomes, reduced depression, reduced anxiety, things like that. But, you know, really having that decreased loneliness and socialized relation, especially in older adults, I mean, we know that that has so many positive mental and physical health outcomes. 00;07;33;15 - 00;07;37;20 Jordan Steiger So I think the fact that you're providing that in your community is such a great thing. 00;07;37;22 - 00;07;39;20 Donetta McVicker Yeah, absolutely I agree. 00;07;39;22 - 00;07;59;24 Jordan Steiger So one thing that we know is on everyone's mind across the country, whether it's, you know, small critical access hospital or a big health system is workforce. And having the right workforce available in the community and in the hospital to fulfill and, you know, continue programs like this. So who do you need to be successful in this program? 00;07;59;24 - 00;08;06;28 Jordan Steiger Do you have, you know, a psychiatrist? Do you have social workers? Tell the audience a little bit more about who's on your team. 00;08;07;01 - 00;08;27;13 Donetta McVicker Yeah. Our program is made up of multidisciplinary cast or, staff. We have a registered nurse. We have a licensed social worker. We have a psychiatrist and other clinical staff that support the patients such as CNAs and things like that, NAs. 00;08;27;13 - 00;08;42;06 Jordan Steiger I think that multidisciplinary approach is always helpful in behavioral health and, you know, gives our listeners an idea maybe what it would take for them, you know, to put something like this in place, knowing that they're going to need lots of different people, lots of different moving parts to kind of make this a success. 00;08;42;08 - 00;08;43;02 Donetta McVicker Yeah. 00;08;43;04 - 00;09;08;06 Jordan Steiger So one thing I know, we hear a lot about and, you know, the behavioral health world in general, and especially with aging adults and rural communities is stigma. You know, stigma around seeking care, stigma about actually admitting that you need help with your mental health. is this something that you found to be true, when you're seeing people coming into your geriatric IOP program? 00;09;08;09 - 00;09;33;19 Donetta McVicker Yes. Of course. You know, one thing that we tell our patients or anyone considering the program is that there is no shame or stigma in providing good self-care. Mental health care should be no different than physical health care. There are nearly 58 million adults aged 65 and older living in the United States, yet we continue to lack services specifically for that population. 00;09;33;21 - 00;09;52;08 Donetta McVicker Unfortunately, the aging process does not come with an instructional manual. However, our program helps to provide resources and the tools, both emotionally and socially, to be better equipped on ways to overcome some of these challenges that often accompany this journey. 00;09;52;10 - 00;10;10;20 Jordan Steiger I love what you said about aging doesn't come with the manual. I think that's, you know, something to keep in mind, you know, here and nobody knows exactly how it feels as people are getting older. It's a really great thing I think, that you have something in your community to provide some structure and provide some guidance. 00;10;10;20 - 00;10;32;14 Jordan Steiger And, like you said, there is no stigma. There should be no stigma around seeking care, especially when it can improve the quality of your life as much as you've seen for your patients. So that's really, really great. Speaking of that, how has your geriatric IOP program positively impacted your patients, families and community? 00;10;32;17 - 00;10;37;14 Donetta McVicker I actually have a few testimonials if I may be permitted to read some of them. 00;10;37;20 - 00;10;38;23 Jordan Steiger Absolutely. 00;10;38;28 - 00;11;06;21 Donetta McVicker All right. So I have: "Since retirement, I needed to reassess who I am and how I occupy my mind. I found the direction and the support with this program." Another client wrote, "I lost my grandchild and found myself in a dark place. I didn't know how I would make it through without the support that I needed. With the help of this program 00;11;06;21 - 00;11;38;00 Donetta McVicker I have made friends and found ways to celebrate her life." And then lastly, one client stated, "I have learned a lot about myself and how to cope with my current health conditions." So as you can see, there are many different ways that patients have experienced an increase in their knowledge of themselves, of their, newly occurring health conditions, which seems like once you're 65 or older, those seem to be more rapidly occurring in their life. 00;11;38;02 - 00;12;04;23 Donetta McVicker And then, you know, losing a loved one seems to happen more frequently in the ages of 65 and older. And unfortunately, it doesn't just stop with the spouse or a friend or a relative or something like that. What we're seeing a lot here is they're losing their adult children or even their grandchildren to things like substance abuse and accidents and things like that. 00;12;04;23 - 00;12;30;07 Donetta McVicker So we're seeing a lot of grief in our program. It's really nice that, you know, that testimony about losing her grandchild. It's really nice to hear that we were able to help her really change her perspective on that grief and flip it around to say how she now has found ways to celebrate that life instead of mourning the loss of that individual. 00;12;30;10 - 00;12;51;19 Jordan Steiger Yeah. I mean, we know that community is such a powerful tool in addressing grief. And, I love that you brought in some patient perspective and you know, testimonial. I think that really kind of brings to life the importance of this program in your community. And I'm sure our listeners are also going to be really impacted by those testimonials as well. 00;12;51;22 - 00;13;09;01 Jordan Steiger So as we kind of wrap up our conversation today, if there is another rural or critical access hospital out there who, you know is hearing the work that you're doing and hearing your story and is like, wow, I would love to have something like that in my community. What advice would you give them as they were getting started? 00;13;09;03 - 00;13;38;27 Donetta McVicker You know, honestly, I would start off and say, take a look around your community. Do you have resources readily available for your most vulnerable populations? The aging process has a host of challenges. So the population often experiences things like grief and financial struggle, isolation, loneliness, chronic health conditions, and just an overall lack of support. A program like Senior Life Solutions can help accommodate those needs. 00;13;38;29 - 00;14;02;25 Donetta McVicker I know that through our program, it didn't take a whole lot to get started here. It's a small staff. Like I said, we have a registered nurse, a CNA, a licensed therapist, and a psychiatrist. And with that small multi-disciplinary staff, we're able to, you know, do really big, important things for our clients. 00;14;02;28 - 00;14;20;18 Jordan Steiger That's great. And I think, you know, the message that it doesn't maybe take a lot to get this off the ground, I think is important. And, you know, of course it's going to take effort to start a new program or something like that. But I think the payoff from what you've said is totally it's worth the work, right, to provide those services to your community. 00;14;20;21 - 00;14;25;20 Jordan Steiger Dana, any closing thoughts from an administrative perspective? 00;14;25;23 - 00;14;52;11 Dana Gould Sure. Financially, the program has been beneficial for us. Since we are a critical access hospital, our reimbursement is, at least for Medicare, is primarily based on our cost. So this allows you to be fully reimbursed for the cost of the program because the majority of the patients are Medicare patients and then also assist with some of the allocated costs that that go to the program. 00;14;52;15 - 00;15;01;11 Dana Gould Some of your overhead costs can be allocated and reimbursed. So financially, it is a very good program for critical access hospital. 00;15;01;14 - 00;15;22;24 Jordan Steiger That's great. That's really important to mention I think, because of course we can't avoid that conversation talking about the finances and how to keep these programs running. So I'm glad that it has been a financially viable program for you and that it continues to be successful. So thank you both so much for sharing your insights with us today. 00;15;22;27 - 00;15;31;19 Jordan Steiger I think that our members at the AHA really going to learn a lot from this conversation, and we really appreciate that you took the time to share with us. 00;15;31;22 - 00;15;40;03 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </details></div> Wed, 22 May 2024 08:57:18 -0500 Geriatric AHA podcast: Integrating age-friendly care in the emergency department /news/headline/2024-03-15-ahapodcast-integrating-age-friendly-care-emergency-department A specialist in geriatrics at Sharp Grossmont Hospital in La Mesa, Calif., shares how the Age-Friendly Health Systems initiative and geriatric accreditation for its emergency department helped it improve care for older patients. <a href="/advancing-health-podcast/2024-03-15-integrating-age-friendly-care-emergency-department-sharp-grossmont?utm_source=newsletter&amp;utm_medium=email&amp;utm_campaign=aha-today">LISTEN NOW</a>&nbsp; &nbsp; Fri, 15 Mar 2024 15:06:00 -0500 Geriatric Enhancing Care for Older Patients with Age-Friendly Health Systems /advancing-health-podcast/2023-07-12-enhancing-care-older-patients-age-friendly-health-systems The population of adults ages 65 and older will exceed 95 million in the United States by the year 2060. As Americans age, hospitals and health systems need to adapt their models of care to address the unique needs of older adults. In this episode, Sonja Rosen, M.D., chief of geriatrics at Cedars-Sinai, shares updates on their journey as an Age-Friendly Health System, and discusses a multidisciplinary approach to providing quality care for older patients in the midst of a workforce shortage. <hr /> <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> · <a href="https://soundcloud.com/advancinghealth/230113-agefriendlypodcast" target="_blank" title="Enhancing Care for Older Patients with Age-Friendly Health Systems">Enhancing Care for Older Patients with Age-Friendly Health Systems</a></div> &nbsp; <details class="transcript"><summary> <h2 title="Click here to open/close the transcript.">View Transcript &nbsp;</h2> </summary> 00;00;01;01 - 00;00;51;04 Tom Haederle The population of adults age 65 or older will exceed 95 million of the United States by the year 2060. As Americans age, our hospitals and health systems need to adapt their models of care to address the unique needs of older adults. Welcome to Advancing Health, a podcast from the �� Association. I'm Tom Haederle with AHA Communications. Age Friendly Health Systems is a movement that aims to enhance care for all older adults by implementing the "4Ms" framework, focusing on what matters to the patient... 00;00;51;10 - 00;01;21;22 Tom Haederle their medications, mentation and mobility. Age Friendly Health Systems is an initiative of the John A. Hartford Foundation and Institute for Health Care Improvement, in partnership with the HRA and the Catholic Health Association of the United States. In this podcast, Sonja Rosen, M.D., chief of geriatrics at Cedars Sinai, shares updates on the health system's age friendly journey and discusses a multidisciplinary approach to providing quality care in the face of a workforce shortage. 00;01;22;08 - 00;01;28;14 Tom Haederle She's in conversation with Raahat Ansari, senior program manager at the AHA. 00;01;28;17 - 00;01;50;08 Raahat Ansari Thank you for joining us again, Dr. Rosen. We're so excited to continue our conversation with you and get updates on your age friendly journey. You've collaborated with us on a few resources to date. And for those listeners who might be joining us for the first time, can you tell us how and why Cedars-Sinai Medical Center decided to begin their age friendly journey and talk a little bit about your role? 00;01;50;26 - 00;02;20;06 Sonja Rosen Absolutely. And thank you again so much for having me back. It's so exciting to be able to share this work with you and with your listeners. Cedars-Sinai has the very unique distinction of caring for more patients over the age of 80 than any other academic medical center in the country. And that population is going to more than double in less than a decade. 00;02;20;06 - 00;02;48;25 Sonja Rosen So by 2030, we're going to have more than 70 million people over the age of 65 in this country. And that's really because of the baby boomers all aging in within the next decade. And so nowhere are we going to feel that growth more acutely than the Cedars-Sinai, where our demographic is already that we care for more patients over the age of 80 than anywhere else. 00;02;49;02 - 00;03;08;25 Sonja Rosen And so we really saw the need to focus on optimal models of care to take care of our older patients and help them successfully age in place. And that is really best personified in the age friendly health system movement. 00;03;09;10 - 00;03;22;22 Raahat Ansari That's so great. Thank you so much for sharing. And I want to talk a little bit about what your role was with the geriatric fracture program and how it got started and what you did to initiate it. 00;03;23;09 - 00;04;10;17 Sonja Rosen So the geriatric fracture program was a great example of an organic program where you had different specialists interested in the same outcome. We all came together to make that happen. It really started in the Department of Orthopedics. The Chair of Orthopedics, Dr. Mark Morris, was a big champion of optimal perioperative care for older persons. He had come from MGH and came to Cedars with that in mind, and he had an amazing nurse practitioner who was the leader of that program, Kathy Brita, who had also helped create that model in her prior institution. 00;04;11;10 - 00;04;59;13 Sonja Rosen So when they came here, they look to partner with geriatrics and found me. And together we really and and also with the partnership of the leading hospitalist group in our health system, created the geriatric fracture program. And that involved reviewing what other programs fracture services had existed, had been put into practice, and then really creating something that would work in our system, which is a pluralistic health care system where we have three hospitalist services, multiple private physicians, a robust orthopedic trauma department, and a lot of different outpatient physicians. 00;04;59;29 - 00;05;33;00 Sonja Rosen And so what we ultimately created was a very organized service that really touches the patient the minute they step into the emergency room with focus on decreasing time to surgery, ultimately thereby decreasing length of stay. And were pleasantly surprised, but maybe not completely surprised that this also decreased direct cost to our health system. And that, of course, helped secure future funding for additional members of this program. 00;05;33;00 - 00;05;51;16 Sonja Rosen And the program has really grown. And then in addition to that, we really focused on how to make sure that when patients leave the hospital, they still have their bone health addressed and strategies for future fall prevention addressed so that these things don't happen again. 00;05;51;29 - 00;06;13;10 Raahat Ansari That's fantastic to hear and I'm so impressed by those outcomes that you shared. We're going to get back to that in just a little bit. What we'll do will delve a little deeper on that piece. But what I want to start out with was I know that the last time we spoke, we had talked a little bit about COVID and the impact that it had on your organization and how you cared for your patient population. 00;06;14;09 - 00;06;46;10 Raahat Ansari With our conversation today, I want to start with a different challenge that many health care organizations are experiencing. Workforce. We understand there is a workforce shortage fueled by the great resignation, and there is a significant percent of the aging population moving toward retirement, which could potentially result in gaps of coverage in the workforce. Additionally, on the flip side, a large portion of the population is turning 65 and older, and we know that there is a current shortage in primary care providers and geriatricians. 00;06;47;03 - 00;06;55;02 Raahat Ansari With all of that in mind. Can you talk about how age friendly care can help alleviate some of that burden that stems from these workforce challenges? 00;06;55;15 - 00;07;28;29 Sonja Rosen Yes, those are such great points. One of the great advantages to the Age Friendly Care Model is that you're creating a model of care that really anyone involved in the care of the patient within that model can participate in. So as you said, we have really always had a shortage of geriatricians. So we know that most care for older persons is not going to be directly provided by geriatricians. 00;07;29;06 - 00;07;58;26 Sonja Rosen As geriatricians, we can serve as subject matter experts, as leaders in creating and implementing these models of care, and certainly also providing direct care. But it's never going to be enough of us to provide all the direct care to older patients. Nor does there really need to be, right? Because they're really every specialty other than pediatrics is providing that care for our older population. 00;07;58;26 - 00;08;29;14 Sonja Rosen And the majority of care for our older population is going to be provided by non-jury commissions. And so and that's great. That's you know, that's sort of the way of the world. And what we want to do is we want to help all of those providers taking care of our older patient population, provide the best care possible. And the 4M's framework allows for that to happen. 00;08;29;28 - 00;09;04;05 Sonja Rosen So creating programs that encompass the 4M's or EMS framework to focusing on what matters most to our older patients. Patients mentation, patients mobility and medication safety. By doing so, really in any program, we're going to help ensure that we're providing optimal care for our older patient population without necessarily having a geriatric provider directly providing that service. 00;09;04;25 - 00;09;31;00 Raahat Ansari That makes a lot of sense. I love hearing how you're finding success in that interdisciplinary work. Let's talk a little bit about the impact of this work, which I know you were starting to touch on just a moment ago. So last time we spoke about 2 to 3 years ago, a few of the outcomes you shared specific to the geriatric fracture program were an improvement by more than 40%. 00;09;31;04 - 00;09;55;23 Raahat Ansari in timed surgery, which meant that patients were not waiting for surgery, and that resulted in fewer complications. You saw a decrease in length of stay by more than 10%. You saw that patients had quicker recovery times. You saw a decrease by more than 12% in direct cost of patient care. And ultimately patients were less likely to be readmitted or returned to the hospital with similar injuries. 00;09;56;28 - 00;10;07;21 Raahat Ansari That was all amazing work, and I can imagine that you have additional outcomes to share. Can you talk a little bit about some of those outcomes and any new impacts over the past few years that you would like to share? 00;10;08;23 - 00;10;45;04 Sonja Rosen Yes, thank you for that. So that those results for our first year pilot program results. Since then that we have studied this population for a total of three years and recently published that work in this special age friendly issue of health services research in February this year. So we study patients 65 and older with non-spine traumatic fractures who are managed by the orthopedic faculty, surgeons and participating hospitalist groups. 00;10;45;29 - 00;11;18;27 Sonja Rosen And again, this program is led by a geriatric nurse practitioner or R.N. in the hospital for direct day to day care. We enrolled 746 patients over three years in this program, in the GFP program, and we compare that to patients that were not enrolled in that program or 852 patients over that same time period. And we collected that data from July of 2018 to June of 2021. 00;11;19;16 - 00;11;53;12 Sonja Rosen And our principal findings remained. Our patients that were enrolled in the geriatric fracture program had lower length of stay with statistical significance. So patients that were enrolled in the program, their average length of stay was four and a half days, and patients that were not enrolled in the program, their average length of stay was 6.3 days. And we also looked at the visit length of stay index and all that was also statistically significant. 00;11;53;23 - 00;12;30;27 Sonja Rosen The length of stay index for patients enrolled in the geriatric fracture program was .9 and for those not enrolled, 1.2. And again, probably not surprisingly, with a decreased length of stay, we found a significant decrease in direct cost in patients of about $5,000 or a quarter of the care. So very significant findings that sort of reinforced what we had seen in the first year pilot to over a three-year period of time. 00;12;31;19 - 00;12;56;02 Raahat Ansari Those are amazing stats and something that you and your team should be so proud of. Thank you for sharing. I do understand that this age friendly work has now expanded across Cedars-Sinai Medical Center to other departments. This is a great example of what a successful age from the organization looks like. You started in one department and worked to implement the framework in a way that made sense to that department that had amazing outcomes to show clearly. 00;12;56;22 - 00;13;15;24 Raahat Ansari Then you spread this work to other departments, tailoring the same framework to fit those other departments processes. Can you share some outcomes or talk a little bit about the work that is being done within these other departments at Cedars-Sinai? And talk a little bit about the next steps of this work at your organization. 00;13;16;08 - 00;13;49;06 Sonja Rosen Absolutely. So first of all, share a little bit more about our geriatric fracture program. So that has grown in that we have increased its scope and focus. We have added a more formal fraction liaison service with a transitional coach and bone health coach within orthopedics and then placed a lot of focus in the outpatient setting on ensuring that these our patients come to see us in ambulatory geriatrics for bone health and call prevention. 00;13;49;25 - 00;14;13;29 Sonja Rosen And this program is now expanding to all of the providers in the hospital, including the private physician. So it's been really wonderful to see that take place. It's been very organic in that people who have not been involved with the program want to be involved with the program because the outcomes are so great, everyone sees how well patients do in the program. 00;14;13;29 - 00;15;12;06 Sonja Rosen So that's been very gratifying. And as I said, really wonderful to see that sort of organically happen over time. And really what we've seen throughout the health system is so many incredible leaders and cures for older patients. Formally doing so and writing the age friendly way. For example, our incredible emergency department under the leadership of Dr. Sam Trapani, has become a geriatric certified emergency room, or GETA certified and actually has a and now has a geriatric education nurse specialist helping to provide that care and now has a designated senior care unit space for appropriate patients adjacent to part of the emergency room. 00;15;12;22 - 00;15;59;04 Sonja Rosen And that that's just happened over the last couple of years. And that's really been an incredible service to our older patient population in the emergency room. We've also seen the growth of a dementia care program under Dr. Zaldy Tan in the last five years, and that is both in the outpatient setting and the inpatient setting as well. Our amazing volunteers have done incredible work in what's called the TLC program, where specific volunteers and we have such a robust volunteer workforce here that sort of joined forces with the emergency room efforts in seeing patients in the emergency room who are at risk for delirium and helping to intervene and to help prevent delirium in those patients. 00;15;59;20 - 00;16;29;15 Sonja Rosen Obviously, these are volunteers that have specialized training in how to do so. But that program has been incredibly helpful and well received by our patient population and also the the emergency room staff. So we're looking at expanding that to other parts of the hospital. And then I want to mention our lead program, leveraging exercise to age in place to combat social isolation and loneliness. 00;16;30;01 - 00;16;59;28 Sonja Rosen I think I might have touched on this before and our in the last podcast, this is a program with Dr. Alice Mayes who's the principal investigator where we demonstrated that evidence based practices in the community helped decrease social isolation and loneliness. So these classes that help prevent falls also with statistical significance as measured by the the UCLA three item loneliness scale, decreased social isolation and loneliness. 00;17;00;16 - 00;17;30;08 Sonja Rosen During the pandemic, these classes went virtual. We're now able to offer them both virtually. We learned that's a good thing for some people that can't come into classes. But we've also gone back to in-person classes. And that program, which was initially funded by a grant from the AARP Foundation, has now become a sustainable program taken on by our community benefits program because we thought what a great success it was and already have these partnerships in the community. 00;17;30;08 - 00;18;22;02 Sonja Rosen So that's now an ongoing program that we're able to offer our not only our patients, but our community. So a lot of just wonderful things like that where we have incredible physicians, nurses, leaders in their area formally riding the wave of age friendly and formalizing these incredible programs. I'd like to add one more thing. When we're a program that's really grown in the last few years, and that has been our efforts in addressing social determinants of health in our entire population, but with a specific focus on our older population, because we know that our older population in Los Angeles is at such high risk for housing insecurity and financial insecurity and social isolation and loneliness. 00;18;22;15 - 00;18;53;24 Sonja Rosen And our community benefits department, under the leadership of social worker Katy Brand, has developed a robust social determinants of health screening tool that's actually embedded in our electronic medical records and hired community health coaches to help our patients who screened positive. And this is done in several different settings. This is done in the emergency room. This is done in the ambulatory clinics, and this is also done in the hospital. 00;18;54;13 - 00;19;25;08 Sonja Rosen So we've seen a lot of increased awareness and ability to address social determinants of health in our older population with this program. This program links to community partners who can then help our patients in these different areas. So I really encourage implement formal screening programs for social determinants of health and connecting to community partnerships to help meet our community's needs. 00;19;26;04 - 00;19;54;28 Raahat Ansari That is so amazing to hear. And I love how you touched on two important groups of people that might not always come to the forefront, but when people are looking into support, one being the volunteer group and also leveraging your community partnerships and making sure that you are able to make the best use of those partnerships. So, love how you tied those two really key partners into this work. 00;19;55;09 - 00;20;12;28 Raahat Ansari One more question for you. As you are expanding this work, can you talk a little bit about some specific successes or challenges that you and your team had to work through? And any tips that you would share for other other organizations that might be experiencing similar things? 00;20;13;13 - 00;20;45;07 Sonja Rosen Yeah, I think probably the first one that comes to mind is sort of starting out the geriatric fracture program several years ago, but at the time it was a completely new concept for the hospitalist and also many of the orthopedists and also for the other health care teams involved in the care of the patient. From admission to the ED...anesthesia is critical in this. Pharmacy is critical in this, physical therapy, etc.. 00;20;45;07 - 00;21;13;08 Sonja Rosen And so what we had to do was really bring everyone together. And that involved a lot of meetings with our key stakeholders. And everyone that I just mentioned were our key stakeholders and anyone involved in the care of a patient during this transition from coming into the hospital with a traumatic fracture to leaving the hospital and having those regular meetings. 00;21;14;07 - 00;21;55;04 Sonja Rosen As we created the program, as we implemented the program, as we began to see results, that was really key in everyone being a part of the change. And so rather than prescribing a program and asking others to adapt it, having them actively engaged in the development of the program was absolutely key to the success. And then in terms of challenges, starting smaller with one partner in our hospital program, one hospital's group and demonstrating success was really key to other hospitalist groups wanting to be a part of that success. 00;21;55;14 - 00;22;10;21 Sonja Rosen Listen, it's great to start smaller demonstrate results. It's easier to implement with a smaller program and then spread the program once you've demonstrated success. So I think that would be the other the other problem. 00;22;11;09 - 00;22;34;28 Raahat Ansari Thank you so much for sharing that. And I just love hearing those pieces of advice as that's exactly how we share our educational content during our action communities, which you have been a part of. So joining an action community to support the implementation of the 4M's framework at your organization. So I know we're coming up on time. 00;22;34;28 - 00;22;51;10 Raahat Ansari And the one last question that I want to leave our listeners with is, as a person who has worked in this age friendly space for some time now, what is the one thing you wish you knew earlier in your journey or one piece of advice that you would share with a care team who is contemplating starting this age friendly journey? 00;22;52;04 - 00;23;20;15 Sonja Rosen Don't hesitate. You're probably already doing the work. This is an opportunity to formalize that work to share the importance of that work with your larger community in your health system. So I would say don't hesitate. Join an action community. Begin the process of becoming age friendly today and be vocal about it. Share that work with your with your health system 00;23;20;15 - 00;23;52;07 Sonja Rosen colleagues, with your health system leadership so that they too want to ride the wave to become friendly. This is something you want to celebrate. You want to help get internal recognition for because that's going to motivate others to join. And the other part of that is collaboration. Collaboration is key, that that is really, I think, ultimately the only way to successfully implement sustainable programs across the health system. 00;23;52;20 - 00;24;31;12 Sonja Rosen So working with many different disciplines, different people in different disciplines, different health care professionals in different disciplines, whether it's physicians, administrators, nurses, volunteers, etc., be open minded, and where you see there's passion or you see there's a spark of interest, that's a great place to start. It might not be necessarily who you thought you were going to start a program with, but it's who's doing the work right now and take it and run with it. 00;24;32;16 - 00;24;43;10 Raahat Ansari I love that. Thank you for all of your insights and for your expertise for being here with us today and for most of all, for your dedication to this important work. Thank you again, Dr. Rosen. 00;24;44;00 - 00;24;45;07 Sonja Rosen Thank you so much. </details> Wed, 12 Jul 2023 16:36:46 -0500 Geriatric