Project ECHO Logistics

Project ECHO:Extension for Community

Healthcare Outcomes at the BIDMC

Team ECHO-AGE

• Sheila Rhea-Nobles – Admin. Coordinator

• Angela Catic – Deputy Director

• Melissa Mattison – Deputy Director

• Lew Lipsitz – Team Director

• Dan Press – Team Neurologist

• Jason Strauss – Team Geriatrics Psychiatrist

Contact Info

Sheila : 617-632-8692

Fax: 617-632-8673

snobles@bidmc.harvard.edu

Projectecho@bidmc.harvard.edu

Logistics

• Twice monthly ECHO-AGE Clinics– Wednesdays, 11:30 am-1:30 pm

• First ECHO-AGE Clinic = June 13

Case Discussions

15 min Educational

Pearl

Select CaseFax

Template, Med List,

Clock Draw

TemplateMed List

Clock Draw

14d 7d

2d

1d

Order of Cases

Emailed

• Initial ECHO-AGE Clinic – Delirium and Dementia in short-term rehab

and long-term care

• Future ECHO-AGE Clinics:– Pain management– Falls/Syncope– Diabetes– Bone health

Select CaseFax

Template, Med List,

Clock Draw

TemplateMed List

Clock Draw

14d 7d

2d

1d

Order of Cases

Emailed

Template

• ECHO ID # will be assigned at the time of first presentation. Please include for follow-up case presentations.

• Bradykinesia - slowness of movement

• Rigidity – Dr. Press to explain

• Geriatric Depression Score

Clock Drawing

1. Ask patient to draw a clock like they would see on the wall

2. Place all the numbers on the face of the clock

3. Set the time for “10 minutes past eleven”

4. If patient cannot draw a circle, you may provide this, but please indicate this on the form

Continence

• Refers to urinary incontinence

• New fecal incontinence is important to note as well

Digit Span TestsForward:

815259496153913867276238426738931687354896215872397168243586591427538712469317954826

Backward:

5169582174729597355689171948153296417839371694891348724856312952843761

Normal Digit Span Forward ~7. Normal Digit Span Backward should not differ from Forward by more then 2 digits

Overall ECHO-AGE Evaluation

1. Operational

2. Educational

3. Patient Focused

4. System based

Ongoing assessmentto better meet your needs

Operational

• Satisfaction– PLEASE complete your survey from today’s

meeting and turn into Sheila before you leave

• Logistics

Educational

• Improved confidence caring for elders with delirium and dementia

• Knowledge gains regarding delirium and dementia diagnosis and management

*Patient Focused*

• Data collection - vital to success and expansion to other clinical topics

• Identify lead contact from your site to work with Sheila on data collection

• Data – Antipsychotic use– Admissions to acute care hospitals– Mortality– Social Engagement– Functional status (score calculated from MDS)

System Based Metrics

• Cost ($)

• Preventable transfers of care

• Quality metrics– Compliance with antipsychotic administration

and physical restraint guidelines