Featured Research

from universities, journals, and other organizations

Managing geriatric patients offers framework for improved care for those with complex health problems

Date:
March 11, 2014
Source:
Johns Hopkins Medicine
Summary:
Efforts to improve the care of older adults and others with complex medical needs will fall short unless public policymakers focus not only on preventing hospital readmission rates, but also on better coordination of community-based “care transitions,” a large group of researchers has concluded. Lessons learned from managing such transitions for older patients, they say, may offer a framework for overall improvement.

A large team of experts led by a Johns Hopkins geriatrician reports that efforts to improve the care of older adults and others with complex medical needs will fall short unless public policymakers focus not only on preventing hospital readmission rates, but also on better coordination of community-based "care transitions." Lessons learned from managing such transitions for older patients, they say, may offer a framework for overall improvement.

Related Articles


Nationwide, some 22 percent of older adults experience so-called care transitions annually, moving from and among hospitals, rehabilitation facilities, nursing homes, long-term care, assisted living and their homes. In a report published online in the Journal of General Internal Medicine on Feb. 21, 2014, the experts say studies have long shown that fragmented care, incomplete information "handoffs" and poor planning among community-based and home caregivers jeopardize health and safety.

Similarly, the team says, those with traumatic brain injuries, cancer, end-stage kidney failure, complicated diabetes, heart disease, developmental disabilities and cerebral palsy need better coordination of their care across health care settings.

Using a review of research and clinical experience, the authors built their framework and recommendations for improving care on the foundation of what's been learned about caring for aging Americans.

Among their recommendations for health policymakers and caregivers are the need to engage community-based care "receivers" earlier in the transition process, to adopt a palliative care approach with patients and their families that sets realistic care goals, and to focus not only on preventing hospitalization, but also on making out-of-hospital transitions easier.

"In this framework, emphasis is placed on the importance of looking at community, system and regional factors that play into care transitions," says report co-author Alicia I. Arbaje, M.D., M.P.H., director of transitional care research for Johns Hopkins Bayview Medical Center and assistant professor of medicine at the Johns Hopkins University School of Medicine.

Many of the group's recommendations focus on communication among providers. For example, Arbaje says, hospital staff should not only make follow-up phone calls to check on discharged patients, but they should also send written care instructions. Family members and caregivers should be a part of patient education during discharge. Small chores, such as alerting a skilled home health care provider well in advance of a patient's discharge, can make coordinating care and recovery plans more effective.

"Our suggested framework is designed to help providers think ahead instead of reacting during a patient's crisis," says Arbaje. Recovery and emergency contingency plans need to be broader than referring a patient back to a primary care physician and instead include other components of an individual patient's health care system and support.

"These findings shed light on what we can do as a health system and community to reduce readmission rates by looking at more than just the patient. The conceptual framework gives structure to understand problems with care transitions and outlines what and who to consider when planning and implementing them. It can be a valuable tool for health care systems and policymakers to guide care coordination efforts as part of health care reform," she says.


Story Source:

The above story is based on materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Alicia I. Arbaje, Devan L. Kansagara, Amanda H. Salanitro, Honora L. Englander, Sunil Kripalani, Stephen F. Jencks, Lee A. Lindquist. Regardless of Age: Incorporating Principles from Geriatric Medicine to Improve Care Transitions for Patients with Complex Needs. Journal of General Internal Medicine, 2014; DOI: 10.1007/s11606-013-2729-1

Cite This Page:

Johns Hopkins Medicine. "Managing geriatric patients offers framework for improved care for those with complex health problems." ScienceDaily. ScienceDaily, 11 March 2014. <www.sciencedaily.com/releases/2014/03/140311162819.htm>.
Johns Hopkins Medicine. (2014, March 11). Managing geriatric patients offers framework for improved care for those with complex health problems. ScienceDaily. Retrieved December 18, 2014 from www.sciencedaily.com/releases/2014/03/140311162819.htm
Johns Hopkins Medicine. "Managing geriatric patients offers framework for improved care for those with complex health problems." ScienceDaily. www.sciencedaily.com/releases/2014/03/140311162819.htm (accessed December 18, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, December 18, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Kids Die While Under Protective Services

Kids Die While Under Protective Services

AP (Dec. 18, 2014) As part of a six-month investigation of child maltreatment deaths, the AP found that hundreds of deaths from horrific abuse and neglect could have been prevented. AP's Haven Daley reports. (Dec. 18) Video provided by AP
Powered by NewsLook.com
UN: Up to One Million Facing Hunger in Ebola-Hit Countries

UN: Up to One Million Facing Hunger in Ebola-Hit Countries

AFP (Dec. 17, 2014) Border closures, quarantines and crop losses in West African nations battling the Ebola virus could lead to as many as one million people going hungry, UN food agencies said on Wednesday. Duration: 00:52 Video provided by AFP
Powered by NewsLook.com
When You Lose Weight, This Is Where The Fat Goes

When You Lose Weight, This Is Where The Fat Goes

Newsy (Dec. 17, 2014) Can fat disappear into thin air? New research finds that during weight loss, over 80 percent of a person's fat molecules escape through the lungs. Video provided by Newsy
Powered by NewsLook.com
Why Your Boss Should Let You Sleep In

Why Your Boss Should Let You Sleep In

Newsy (Dec. 17, 2014) According to research out of the University of Pennsylvania, waking up for work is the biggest factor that causes Americans to lose sleep. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins