Implementation of a Volunteer-Based Hospital Visitation Program for Older Adults

This research suggests that a volunteer program has a positive impact on hospital delirium, with longer visits having more effect

Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer.

PURPOSE: The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record extraction compared with a pharmacist-led comprehensive medication assessment. PATIENTS AND METHODS: We retrospectively examined medication use in ambulatory senior adults with cancer to determine the prevalence of polypharmacy (PP) and potentially inappropriate medication (PIM) use and associated factors. PP was defined as concurrent use of five or more and less than 10 medications, and excessive polypharmacy (EPP) was defined as 10 or more medications. PIMs were categorized by 2012 Beers Criteria, Screening Tool of Older Person\u27s Prescriptions (STOPP), and the Healthcare Effectiveness Data and Information Set (HEDIS). RESULTS: A total of 248 patients received a geriatric oncology assessment between January 2011 and June 2013 (mean age was 79.9 years, 64% were women, 74% were white, and 87% had solid tumors). Only 234 patients (evaluated by pharmacists) were included in the final analysis. Mean number of medications used was 9.23. The prevalence of PP, EPP, and PIM use was 41% (n = 96), 43% (n = 101), and 51% (n = 119), respectively. 2012 Beers, STOPP, and HEDIS criteria classified 173 occurrences of PIMs, which were present in 40%, 38%, and 21% of patients, respectively. Associations with PIM use were PP (P \u3c .001) and increased comorbidities (P = .005). CONCLUSION: A pharmacist-led comprehensive medication assessment demonstrated a high prevalence of PP, EPP, and PIM use. Medication assessments that integrate both 2012 Beers and STOPP criteria and consider cancer diagnosis, prognosis, and cancer-related therapy are needed to optimize medication use in this population

A comparison of implementation issues and strategies for radio frequency identification technologies between the U.S. military and private sector organizations

The purpose of this research was to study the implementation of radio frequency identification (RFID) technologies used to track equipment and supplies. Current implementation issues and strategies for future use were collected from leading edge organizations from the military and private sector. A formal comparison found both similarities and differences between how industry and the Army are implementing and using RFID technologies in their supply chains and logistics networks. This article focuses on these similarities and differences, to include a gap between the Army and industry regarding RFID tag use and implementation, and a difference in the overall focus of how RFID tags are or plan to be used in both environments

Evaluation of patient perceptions of team based care in a Geriatric Oncology Clinic

Purpose: To measure patient perceptions of collaborative practice in an interprofessional team providing geriatric oncology assessments to older patients with cancer. Background: The Senior Adult Oncology Clinic (SAOC) at Thomas Jefferson University’s Kimmel Cancer Center utilizes an interprofessional team approach to provide comprehensive geriatric oncology assessments and treatment plans for older patients with cancer. The importance of team-based healthcare delivery is well documented, however, experts agree that there is a need for more tools to assess the skills required to become a high-functioning team and a need to study the impact of collaborative practice on patient reported outcomes and satisfaction. For this study, we sought to evaluate patients’ experience and perception of our SAOC team function. Description of Intervention: Upon completion of a SAOC visit, patients were asked to participate in a short voluntary survey to assess team performance. The Jefferson Teamwork Observation Guide (JTOG) is a validated survey used with learners that has been adapted to elicit patient perspectives of five domains of interprofessional collaborative practice, including communication (C), values/ethics (V/E), teamwork (T), roles/responsibilities (R) and patient-centeredness (PC). The Patient JTOG includes eight competency–based Likert Scale questions as well as one open-ended question. The survey was administered on secure mobile tablets by trained research assistants (RAs) who were not part of the healthcare team. The study received exempt approval by our Institutional Review Board. Results: A total of 13 patients completed the survey. Seven respondents were female, and six were male. Seven identified as Caucasian, four as African American and two as other. One hundred percent responded “Strongly Agree” to a global question about the importance of teamwork in patient care (mean 4.0). Overall satisfaction with the SAOC team was 3.92 out of 4.0. For the eight questions relating to each of the five collaborative practice competencies noted above, the team received an average score ranging from 3.69 to 3.77 out of 4.0, for a global score of 29.66 (out of 32 possible), placing this team in the highest quartile of teams surveyed at our institution to date (n=407). In addition, all 13 respondents completed the open-ended qualitative comments with 12 out of the 13 being positive with multiple references to effective listening and communication, team coordination, and patient-centered care. Conclusion: The SAOC has a relatively unique model of providing interprofessional geriatric oncology assessments. The Patient JTOG tool was easy to incorporate into a busy clinic and provided valuable feedback to our providers, demonstrating that our patient’s perceive the team as highly functioning and effective. Based on these early results, our high functioning interprofessional consultative team model may serve as a model for replication for team based care delivery at other institutions Relevance: Incorporation of an easy to use tool to assess interprofessional team function and patient perceptions of collaborative practice Learning Objectives: Define methods for evaluating patient perceptions of collaborative practice in an outpatient geriatric oncology practice (Knowledge) Describe a replicable model for interprofessional collaborative practice (Comprehension/Application) Apply lessons learned for engaging students in and preparing faculty for interprofessional team-based care delivery (Comprehension/Application

Experience with a Comprehensive Multidisciplinary Geriatric Oncology Center

Research Goals 1. Describe the population seen in the SAOC over the past 6 years Remediate and complete the EPIC flowsheets Merge data with existing RedCAP dat

The Association of the G8 Questionnaire with Treatment Side Effects and Unscheduled Care Among Older Breast Cancer Patients: A Retrospective Cohort Study

Introduction Nearly half of the patients diagnosed with breast cancer are ≥ 65 years. Older patients with breast cancer are at higher risk for experiencing treatment side effects and unplanned health care. This can compromise treatment outcomes and increase the cost of care. The G8 is among the most sensitive screening tools for frailty and mortality. The aim of this study is to evaluate the association of the G8 questionnaire with treatment side effects and unscheduled care in older breast cancer women.https://jdc.jefferson.edu/medoncposters/1017/thumbnail.jp

The Grizzly, February 21, 2002

Former U.S Ambassador to Sierra Leone now Ursinus Professor • Professor Melrose Testifies Before the Senate • Fire in Reimert: Where Were the Smoke Detectors? • Grant Will Enhance Ursinus Asian Studies Program • Marisol: A Lesson in Living in the Aftermath of September 11th • Winter Olympics Take Salt Lake by Storm • Save a Life: Donate Blood at the March Blood Drive • Opinions: Dressing Up: What Happened to Everyone\u27s Style?; Heart-wrenching and Heart-warming Olympics; For the Appropriateness of Fraternities and Sororities on Campus • When Making Love Becomes Sex: Diversifying Love and Sex • Price Comparison: Don\u27t Let the Cold Season Hurt Your Wallet • Pledging in the Past • Women\u27s Basketball Shoots Out Bryn Mawr to end 2002 Season • Men\u27s Basketball Looks Toward Showdown with Franklin & Marshall • Centennial Conference Wrestling Tournament Held at Ursinushttps://digitalcommons.ursinus.edu/grizzlynews/1508/thumbnail.jp

Delirium

Objectives Define delirium Understand the impact of delirium Discuss risks and prevention/management Discuss documentation and delirium at TJU

Implementation of a Volunteer-Based Hospital Program for Older Adults

Background A multi-faceted, volunteer-led, hospital-based program1has been shown to: •Reduce the incidence of delirium •Decrease hospital length of stay •Reduce hospital costs. Implementation of such a program requires upfront investment. A smaller, volunteer-based visitation program for older adults may provide support for the allocation of more hospital resources in delirium prevention and establishment of a formal Hospital Elder Life Program1in this institution. This research aims to investigate: •If the implementation of a visitation program is feasible at this hospital •Volunteer experience with the program.https://jdc.jefferson.edu/patientsafetyposters/1078/thumbnail.jp

Quality Improvement: Assessment of Knowledge and Attitudes Regarding the Confusion Assessment Method Delirium Screening Tool

Project AIMs: Evaluate the need for reeducation efforts on CAM Increase CAM use, comfort and knowledg