3Aging

Quality Education

Quality of Life

Quality Care

Aging QAging Q33

2009 Fall Retreat2009 Fall Retreat

September 25-26, 2009September 25-26, 2009

Importance of Donald W. Reynolds grant to MUSC

• Aging is high profile issue in SCAging is high profile issue in SC

• Demographic imperativeDemographic imperative

• Opportunity to “Gerontologize” Opportunity to “Gerontologize” MUSCMUSC

• Potential broader impact on Potential broader impact on Primary Care (AHEC)Primary Care (AHEC)

Caring for older people is Caring for older people is about Qualityabout Quality

““The degree to which health care services The degree to which health care services for individuals and populations increase for individuals and populations increase the likelihood of desired outcomes and the likelihood of desired outcomes and are consistent with current professional are consistent with current professional knowledge” knowledge” Institute of Medicine 1990Institute of Medicine 1990

Characteristics of high quality of Characteristics of high quality of carecare

• SafeSafe

• EffectiveEffective

• Patient-centeredPatient-centered

• TimelyTimely

• EquitableEquitable

• EfficientEfficient

Quality of care for Vulnerable Quality of care for Vulnerable Elders: The canary in the coal Elders: The canary in the coal minemine

Aging QAging Q33: Chronic Care : Chronic Care ModelModel

Aging Q3 Organizational Chart

rev. 9/1/09

200920091. Vision Loss1. Vision Loss

Chair:Chair: Bill Moran, MD Bill Moran, MDMember IP:Member IP: Pam Pride, MD Pam Pride, MDMember OP:Member OP: Kathy Wiley, MD Kathy Wiley, MDMember:Member: Kim Davis, MD Kim Davis, MDConsultant:Consultant: Black, MD (Ophthal) Black, MD (Ophthal)

2. Falls and Mobility2. Falls and Mobility Chair:Chair: Kathy Wiley, MD Kathy Wiley, MD Member IP:Member IP: Cathryn Caton, MD Cathryn Caton, MD Member OP:Member OP: Member:Member: Cara Litvin, MD Cara Litvin, MD MemberMember: Amy Thompson, : Amy Thompson,

PharmDPharmD

3. Dementia 3. Dementia

Chair:Chair: Pam Pride, MD Pam Pride, MDMember IP: Member IP: Neal Axon, MDNeal Axon, MDMember OP:Member OP: Jay Brzezinski, Jay Brzezinski,

MDMD Member: Member: Vanessa Vanessa

Spearman,MDSpearman,MD

20102010 4. Continuity of 4. Continuity of Care Care

Chair:Chair: Kim Davis, MD Kim Davis, MDMember IP:Member IP: Member OP:Member OP: Member:Member:

5. Urinary 5. Urinary Incontinence Incontinence

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

6.6. Hospital Care & Hospital Care & TransitionsTransitions

ChairChair: Neal Axon, MD: Neal Axon, MD Member IP: Member IP: Member OP:Member OP: Member: Member: Paul Rousseau, MDPaul Rousseau, MD

7. Pharmacologic 7. Pharmacologic ManagementManagement

Chair: Chair: Amy Thompson, PharmDAmy Thompson, PharmD Member IP:Member IP: Member OP:Member OP: Member:Member:

20112011 8. Screening/ 8. Screening/ PreventionPrevention

Chair: Elisha Brownfield, Chair: Elisha Brownfield, MDMD

Member IP:Member IP: Member OP:Member OP: Member:Member:

9. End of Life Care9. End of Life Care

Chair:Chair: Paul Rousseau, MD Paul Rousseau, MDMember IP:Member IP: Member OPMember OPMember:Member:

10. Osteoarthritis 10. Osteoarthritis

Chair:Chair: Cathryn Caton, MDCathryn Caton, MDMember IP:Member IP:Member OP:Member OP: Cara Litvin, MDCara Litvin, MD Member:Member:

11. Osteoporosis11. Osteoporosis Chair: Chair: Member IP:Member IP: Member OP:Member OP: Leonard Leonard

Lichtenstein, MDLichtenstein, MD Member:Member:

20122012 12. Depression12. Depression

Chair:Chair: Member IP:Member IP:Member OP:Member OP:Member:Member:

13/14. Pressure Ulcers 13/14. Pressure Ulcers Malnutrition Malnutrition

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

15. Pain Management 15. Pain Management

Chair:Chair: Paul Rousseau, MD Paul Rousseau, MDMember IP:Member IP: Member OP:Member OP: Member:Member:

16. Hearing Loss 16. Hearing Loss

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

Aging Q3 ACOVE Area and Work GroupsAging Q3 ACOVE Area and Work Groups

200920091. Vision Loss1. Vision Loss

Chair:Chair: Bill Moran, MD Bill Moran, MDMember IP:Member IP: Pam Pride, MD Pam Pride, MDMember OP:Member OP: Kathy Wiley, MD Kathy Wiley, MDMember:Member: Kim Davis, MD Kim Davis, MDConsultant:Consultant: Black, MD (Ophthal) Black, MD (Ophthal)

2. Falls and Mobility2. Falls and Mobility Chair:Chair: Kathy Wiley, MD Kathy Wiley, MD Member IP:Member IP: Cathryn Caton, MD Cathryn Caton, MD Member OP:Member OP: Member:Member: Cara Litvin, MD Cara Litvin, MD MemberMember: Amy Thompson, : Amy Thompson,

PharmDPharmD

3. Dementia 3. Dementia

Chair:Chair: Pam Pride, MD Pam Pride, MDMember IP: Member IP: Neal Axon, MDNeal Axon, MDMember OP:Member OP: Jay Brzezinski, Jay Brzezinski,

MDMD Member: Member: Vanessa Vanessa

Spearman,MDSpearman,MD

20102010 4. Continuity of 4. Continuity of Care Care

Chair:Chair: Kim Davis, MD Kim Davis, MDMember IP:Member IP: Member OP:Member OP: Member:Member:

5. Urinary 5. Urinary Incontinence Incontinence

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

6.6. Hospital Care & Hospital Care & TransitionsTransitions

ChairChair: Neal Axon, MD: Neal Axon, MD Member IP: Member IP: Member OP:Member OP: Member: Member: Paul Rousseau, MDPaul Rousseau, MD

7. Pharmacologic 7. Pharmacologic ManagementManagement

Chair: Chair: Amy Thompson, PharmDAmy Thompson, PharmD Member IP:Member IP: Member OP:Member OP: Member:Member:

20112011 8. Screening/ 8. Screening/ PreventionPrevention

Chair: Elisha Brownfield, Chair: Elisha Brownfield, MDMD

Member IP:Member IP: Member OP:Member OP: Member:Member:

9. End of Life Care9. End of Life Care

Chair:Chair: Paul Rousseau, MD Paul Rousseau, MDMember IP:Member IP: Member OPMember OPMember:Member:

10. Osteoarthritis 10. Osteoarthritis

Chair:Chair: Cathryn Caton, MDCathryn Caton, MDMember IP:Member IP:Member OP:Member OP: Cara Litvin, MDCara Litvin, MDMember:Member:

11. Osteoporosis11. Osteoporosis Chair: Chair: Member IP:Member IP: Member OP:Member OP: Leonard Leonard

Lichtenstein, MDLichtenstein, MD Member:Member:

20122012 12. Depression12. Depression

Chair:Chair: Member IP:Member IP:Member OP:Member OP:Member:Member:

13/14. Pressure Ulcers 13/14. Pressure Ulcers Malnutrition Malnutrition

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

15. Pain Management 15. Pain Management

Chair:Chair: Paul Rousseau, MD Paul Rousseau, MDMember IP:Member IP: Member OP:Member OP: Member:Member:

16. Hearing Loss 16. Hearing Loss

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

Aging Q3 ACOVE Area and Work GroupsAging Q3 ACOVE Area and Work Groups

200920091. Vision Loss1. Vision Loss

Chair:Chair: Bill Moran, MD Bill Moran, MDMember IP:Member IP: Pam Pride, MD Pam Pride, MDMember OP:Member OP: Kathy Wiley, MD Kathy Wiley, MDMember:Member: Kim Davis, MD Kim Davis, MDConsultant:Consultant: Black, MD (Ophthal) Black, MD (Ophthal)

2. Falls and Mobility2. Falls and Mobility Chair:Chair: Kathy Wiley, MD Kathy Wiley, MD Member IP:Member IP: Cathryn Caton, MD Cathryn Caton, MD Member OP:Member OP: Member:Member: Cara Litvin, MD Cara Litvin, MD MemberMember: Amy Thompson, : Amy Thompson,

PharmDPharmD

3. Dementia 3. Dementia

Chair:Chair: Pam Pride, MD Pam Pride, MDMember IP: Member IP: Neal Axon, MDNeal Axon, MDMember OP:Member OP: Jay Brzezinski, Jay Brzezinski,

MDMD Member: Member: Vanessa Vanessa

Spearman,MDSpearman,MD

20102010 4. Continuity of 4. Continuity of Care Care

Chair:Chair: Kim Davis, MD Kim Davis, MDMember IP:Member IP: Member OP:Member OP: Member:Member:

5. Urinary 5. Urinary Incontinence Incontinence

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

6.6. Hospital Care & Hospital Care & TransitionsTransitions

ChairChair: Neal Axon, MD: Neal Axon, MD Member IP: Member IP: Member OP:Member OP: Member: Member: Paul Rousseau, MDPaul Rousseau, MD

7. Pharmacologic 7. Pharmacologic ManagementManagement

Chair: Chair: Amy Thompson, PharmDAmy Thompson, PharmD Member IP:Member IP: Member OP:Member OP: Member:Member:

20112011 8. Screening/ 8. Screening/ PreventionPrevention

Chair: Elisha Brownfield, Chair: Elisha Brownfield, MDMD

Member IP:Member IP: Member OP:Member OP: Member:Member:

9. End of Life Care9. End of Life Care

Chair:Chair: Paul Rousseau, MD Paul Rousseau, MDMember IP:Member IP: Member OPMember OPMember:Member:

10. Osteoarthritis 10. Osteoarthritis

Chair:Chair: Cathryn Caton, MDCathryn Caton, MDMember IP:Member IP:Member OP:Member OP: Cara Litvin, MD Cara Litvin, MD Member:Member:

11. Osteoporosis11. Osteoporosis Chair: Chair: Member IP:Member IP: Member OP:Member OP: Leonard Leonard

Lichtenstein, MDLichtenstein, MD Member:Member:

20122012 12. Depression12. Depression

Chair:Chair: Member IP:Member IP:Member OP:Member OP:Member:Member:

13/14. Pressure Ulcers 13/14. Pressure Ulcers Malnutrition Malnutrition

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

15. Pain Management 15. Pain Management

Chair:Chair: Paul Rousseau, MD Paul Rousseau, MDMember IP:Member IP: Member OP:Member OP: Member:Member:

16. Hearing Loss 16. Hearing Loss

Chair:Chair: Member IP:Member IP: Member OP:Member OP: Member:Member:

Aging Q3 ACOVE Area and Work GroupsAging Q3 ACOVE Area and Work Groups

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Resident Lecture

Identify Patients at the time of care

Cue MDs to act

Provide decision support

Record data on clinical intervention

Assess performance:Extract and analyze Clinical data

Resident Detailing

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Pic: Faculty lecture and Pic: Faculty lecture and RetreatRetreat

Faculty & Intervention Development

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Resident Lecture

Resident Lecture

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Resident Lecture

Resident Detailing

Detailing SheetsDetailing Sheets

Resident Detailing

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Resident Lecture

Identify Patients at the time of care

Resident Detailing

Registration: ID PatientsRegistration: ID Patients

Identify Patients at the time of care

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Resident Lecture

Identify Patients at the time of care

Cue MDs to act

Resident Detailing

Blue SheetBlue SheetCue MDs to act

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Resident Lecture

Identify Patients at the time of care

Cue MDs to act

Provide decision support

Resident Detailing

Provide decision support

Using Practice Partner to provide Decision Support

This note version ONLY comes up for patients 65 and older

From Knowledge to From Knowledge to Performance:Performance:Intervention Sequence for each ACOVEIntervention Sequence for each ACOVE

Faculty & intervention Development

Resident Lecture

Identify Patients at the time of care

Cue MDs to act

Provide decision support

Record data on clinical intervention

Resident Detailing

Record data on clinical interventions

Final Note in Practice Partner

Clinical performance data from Practice Partner

From Knowledge to From Knowledge to PerformancePerformance

Faculty & intervention Development

Resident Lecture

Identify Patients at the time of care

Cue MDs to act

Provide decision support

Record data on clinical intervention

Assess performance:Extract and analyze Clinical data

Resident Detailing

Synchronizing data collection and analysis