Journal of the American Geriatrics Society,
Год журнала:
2024,
Номер
unknown
Опубликована: Окт. 7, 2024
Abstract
Background
For
the
thousands
of
health
systems
recognized
as
Age‐Friendly,
considerable
progress
has
been
made
to
integrate
4Ms
into
clinical
care.
This
study
evaluated
associations
between
documentation
and
patient
characteristics
in
an
inpatient
setting.
Methods
In
this
prospective
cohort,
hospitalizations
included
were
from
patients
Acute
Care
for
Elders
(ACE)
unit
where
adopted
implemented.
Each
M
(What
Matters,
Medication,
Mentation,
Mobility)
was
stratified
three
categories
(not
documented,
partly
fully
documented)
reflecting
“assessment”
“action”
care
processes.
Electronic
records
reviewed
hospitalization
characteristics.
Descriptive
statistics
these
across
each
M.
Results
There
620
hospital
encounters
(573
patients)
cohort.
Patients
had
a
median
age
80
years
[IQR
76,
86]
85%
White.
Of
all
4Ms,
What
Matters
lowest
with
413
(67%)
falling
not
documented
group.
Medication
highest
453
(73%)
Significant
differences
associated
versus
Mobility
(80
[76,
82
[77,
88]
(
p
=
0.019)).
Hospital
length
stay
differentially
4M
categories.
Initial
mobility
scores
(6
[2,
7]
2
6]
0.041)).
Conclusions
We
developed
structured
way
categorize
processes
reflective
(not,
partly,
fully)
identified
important
each.
These
results
offer
opportunities
future
improvement
efforts
insight
which
may
be
measure
wider
adoption
uptake.
Journal of Gerontological Nursing,
Год журнала:
2023,
Номер
49(11), С. 15 - 23
Опубликована: Окт. 31, 2023
Many
nursing
home
(NH)
residents
with
advanced
dementia
receive
burdensome
interventions
rather
than
that
promote
comfort
or
quality
of
life.
The
purpose
the
current
study
was
to
test
usability
a
novel
intervention,
ADVANCED-Comfort,
which
aims
enhance
provision
personalized
care
for
dementia.
intervention
comprises
structured
plan
meetings
between
NH
team
and
proxies
(e.g.,
family
members).
Using
ADVANCED-Comfort
workbook,
create
individualized
plans
addressing
six
domains
adapted
from
Age-Friendly
Health
System
Framework.
this
article
is
describe
its
theoretical
underpinnings
report
evaluated
surveys,
observation,
exit
interviews.
demonstrated
staff
found
usable
(acceptable,
appropriate,
feasible).
Based
on
these
preliminary
findings,
additional
testing
warranted.
[Journal
Gerontological
Nursing,
49(11),
15-23.].
American Journal of Hospice and Palliative Medicine®,
Год журнала:
2023,
Номер
41(11), С. 1297 - 1306
Опубликована: Дек. 19, 2023
Background
Goals
of
care
conversations
are
essential
to
delivery
goal
concordant
care.
Infrequent
and
inconsistent
goals
documentation
potentially
limit
Methods
At
Kaiser
Permanente
San
Francisco
Cancer
Center,
a
standardized
template
was
designed
implemented
increase
by
oncologists.
The
centralized,
prompt-based
included
value
clarification
the
values
advanced
cancer
patients
beyond
treatment
preferences.
Documented
using
during
initial
pilot
period
were
reviewed
characterization
clinical
context
in
which
recorded.
Common
motivators
also
identified.
Results
A
total
178
had
at
least
1
documented
conversation
medical
oncologist
template.
Oncologists
consistently
within
therapy
motivating
factors
decision
making.
most
frequently
“Avoiding
Pain
Suffering,”
“Physical
Independence,”
“Living
as
Long
Possible.”
recorded
“Comfort
Focused
Treatment
Only.”
Conclusions
Review
allowed
for
context,
patients.
Communication
oncologists
centralized
location
has
potential
improve
Archives of Gerontology and Geriatrics Plus,
Год журнала:
2024,
Номер
1(3), С. 100041 - 100041
Опубликована: Май 25, 2024
The
aim
of
this
study
is
to
analyse
adverse
health
outcomes
at
hospital
discharge
adjusted
frailty
degree
measured
by
three
instruments
in
patients
admitted
for
medical
diseases
an
Acute
Care
Elders
(ACE).
This
a
prospective
observational
study,
including
194
frail
aged
75
years
or
older.
Patients
were
tertiary
ACE
acute
illness
exacerbated
chronic
from
June
2022
May
2023.
Frailty
was
assessed
the
FRAIL
scale,
Clinical
Scale
(CFS)
and
frail-VIG
Index
(IF-VIG).
Health
analysed
length
stay,
home
destination
discharge,
development
delirium
functional
decline.
on
average
85,14
old,
with
56%
women.
Mean
punctuations
2,83
scale;
4,1
CFS
0,3
IF-VIG.
who
did
not
return
more
fragile:
3,1
vs
2,6;
4,5
4,0;
IF-VIG
0,2.
hospitalization
longer
than
10
days
3,9
3,8;
More
had
greater
incidence
prevalence:
4,7
4,1;
These
results
are
statistically
significant.
A
basal
during
hospitalisation
strongly
related
smaller
rates
as
well
mean
stay-length
larger
amounts
delirium.
Journal of the American Geriatrics Society,
Год журнала:
2024,
Номер
unknown
Опубликована: Окт. 7, 2024
Abstract
Background
For
the
thousands
of
health
systems
recognized
as
Age‐Friendly,
considerable
progress
has
been
made
to
integrate
4Ms
into
clinical
care.
This
study
evaluated
associations
between
documentation
and
patient
characteristics
in
an
inpatient
setting.
Methods
In
this
prospective
cohort,
hospitalizations
included
were
from
patients
Acute
Care
for
Elders
(ACE)
unit
where
adopted
implemented.
Each
M
(What
Matters,
Medication,
Mentation,
Mobility)
was
stratified
three
categories
(not
documented,
partly
fully
documented)
reflecting
“assessment”
“action”
care
processes.
Electronic
records
reviewed
hospitalization
characteristics.
Descriptive
statistics
these
across
each
M.
Results
There
620
hospital
encounters
(573
patients)
cohort.
Patients
had
a
median
age
80
years
[IQR
76,
86]
85%
White.
Of
all
4Ms,
What
Matters
lowest
with
413
(67%)
falling
not
documented
group.
Medication
highest
453
(73%)
Significant
differences
associated
versus
Mobility
(80
[76,
82
[77,
88]
(
p
=
0.019)).
Hospital
length
stay
differentially
4M
categories.
Initial
mobility
scores
(6
[2,
7]
2
6]
0.041)).
Conclusions
We
developed
structured
way
categorize
processes
reflective
(not,
partly,
fully)
identified
important
each.
These
results
offer
opportunities
future
improvement
efforts
insight
which
may
be
measure
wider
adoption
uptake.
