Improving the Health and Well-Being of Older Americans by Translating Research into Practice

Translating research knowledge into practical advances to benefit the health and well being of older Americans has increasingly become a priority for both agencies. Although there is some adoption of translated, evidence-based interventions into practice, it has been limited and few evidence-based interventions have been brought to scale nationwide. This program announcement encourages applications that focus on the translation of behavioral and social research in aging into the development of new interventions that can be used by community-based organizations that assist elderly individuals. 

Collaborations between academic research centers and community-based organizations with expertise serving the elderly are a top priority.  Partnerships of this nature will enhance our understanding of practical tools, techniques, programs and policies that communities across the nation can use to more effectively respond to needs of their aging populations. The two funding announcements can be found on the NIH website at:
http://grants.nih.gov/grants/guide/pa-files/PA-11-123.html

Fall-Prevention Program Fails from MedPage Today

By Todd Neale, Staff Writer, MedPage Today

A multidisciplinary program to prevent recurrent falls among older people failed to reduce fall rates, according to results of a clinical trial from the Netherlands.

The randomized, controlled clinical trial, conducted among more than 200 people ages 65 and older who had suffered a previous fall, found no statistically significant differences in fall rates within a year between the intervention group and those who received the usual care, Oscar de Vries, MD, of VU University Medical Center in Amsterdam, and colleagues reported in the July 12 issue of the Archives of Internal Medicine.
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Management of long term conditions

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Policy developments strengthening primary care provide the specialty of geriatric medicine an opportunity to review and strengthen its partnership with primary care. The Department of Health has promulgated a three level model for the management of long term conditions: self management, disease management and case management for those with complex and multiple conditions. It is this latter group that geriatricians have most to offer, backed up by the evidence-based practice of comprehensive geriatric assessment.

The British Geriatrics Society Primary and Continuing Care SIG offer a model of care for frail older people, and this is intended to be useful for the effective implementation of services for such people, including case management
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Related articles by Zemanta

• Researchers at Boston University School of Medicine incorporate multisite geriatric clerkship (scienceblog.com)
• The Canadian Geriatrics Society: Answering the Call to Action for an Unprecedented Health Challenge (newswire.ca)
• Accountable Care Organizations (ACOs): A 'Blue Ocean' for the Disease Management Industry? (diseasemanagementcareblog.blogspot.com)

Geriatric Nursing Resources for Care of Older Adults

ConsultGeriRN.org is your source for evidence based and authoritative information about nursing care of older adults.

ConsultGeriRN.org is the geriatric clinical nursing website of the Hartford Institute for Geriatric Nursing, New York University College of Nursing. ConsultGeriRN.org is an evidence-based online resource for nurses in clinical and educational settings. ConsultGeriRN.org is funded in part by a grant from The Atlantic Philanthropies (USA) Inc. and The John A. Hartford Foundation.

What you will find on ConsultGeriRN:

* Geriatric protocols, evidence-based for managing 27 common geriatric syndromes and conditions
* Linkage to 55 specialty nursing associations’ offerings in geriatric care and to national geriatric web-sites
* The Try This Assessment tools series with 30 nationally recommended instruments for use with older adults
* Hospital competencies for older adults for use in nurse orientation and evaluation
* Opportunities to acquire continuing education contact hours and much more!


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Health Care Policy and Marketplace Review: What Voters Really Think About Evidence-Based Health Care

by Bob Laszewski

I want to call you attention to an important survey done by the California-based Campaign for Effective Care. They surveyed California voters on their understanding of evidence-based medicine.

The bad news is that patients think their health care treatment is generally evidence-based even though that assumption is highly questionable. The good news is that patients want it to be evidence-based.

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Myth Busting: Heart Failure Issue

From BP Blogger - Cutting Through the Foggy Myths Using Best Practice Guidelines in Long Term Care Myth 1: Heart failure means your heart has stopped beating Myth 2: Heart failure is normal with aging Myth 3: Heart failure is tricky to recognize Myth 4: Can’t treat heart failure in LTC

Organization Design for Geriatrics: An Evidence Based Approach

From the Regional Geriatric Programs of Ontario, this newly released handbook is aimed at providing an evidence-based approach to service delivery for the elderly patient in core specialized geriatric services. Core services include:

• geriatric rehabilitation
• assessment and consultation
• geriatric outreach
• outpatient clinics
• geriatric day hospitals
• condition-specific units
• innovative areas of care

Each chapter follows the same general layout:

• executive summary
• definition and description of the service
• description of information sources used
• recommendations from the literature

Healthy Aging Programs for Older Adults - Online Training

This is an online training module on evidence-based health promotion for older adults, which is designed primarily for aging services providers. This training module will define health promotion concepts, frameworks and terms, and will provide interactive exercises, downloadable tools and resources that can help the user plan for, implement, and reinforce the quality of health promotion programs.

Evidence of a Need for Change

By: Michael L. Millenson in Miller-McCune: Turning Research Into Solutions How likely is it that you will receive treatment the medical literature says is best? Flip a coin. Evidence-based health care can improve those odds, save lives and cut health care costs dramatically. Experts believe that a stunning 20 to 40 percent of the $2.4 trillion America spends on health care in 2008 will be wasted on misuse (including harmful and fatal errors), overuse (care that’s unnecessary) or underuse (effective care that’s not provided). If you take a midrange figure — let’s say 30 percent — you end up with $720 billion in savings. That’s enough in health care savings to pay the cumulative costs of the Iraq war (about $560 billion by mid-September 2008) and still have enough cash left over to pay for universal health care and the entire federal education budget. If you simply sent out a rebate check, it would come to some $2,100 for every man, woman and child in the country. And that’s just one year of savings. The failure to follow best practice carries a price tag in human lives, too, and it is equally enormous. Providing appropriate, effective and safe care where we know how to do it — no “medical mysteries” included — could annually prevent the deaths of hundreds of thousands of Americans in and out of the hospital and millions of injuries.

Information therapy goes beyond evidenced-based info

By Joshua Seidman in the Health Care Blog

I had a fun meeting recently with some smart folks from the Robert Wood Johnson Foundation that raised questions about Ix that could use some clarification. When we talk about information therapy (Ix), we often drift into “evidence-based information” to help with some specific health condition.

That certainly is an important component of Ix, but it’s too limiting in many circumstances. When we talk about the “proactive delivery of the right information to the right person at the right time,” that has to encompass whatever the information needs of the consumer are.

Discretionary Decision Making By Primary Care Physicians And The Cost Of U.S. Health Care

Brenda Sirovich; Patricia M. Gallagher; David E. Wennberg; and Elliott S. Fisher Medscape Business of Medicine

Efforts to improve the quality and costs of U.S. health care have focused largely on fostering physician adherence to evidence-based guidelines, ignoring the role of clinical judgment in more discretionary settings. We surveyed primary care physicians to assess variability in discretionary decision making and evaluate its relationship to the cost of health care. Physicians in high-spending regions see patients back more frequently and are more likely to recommend screening tests of unproven benefit and discretionary interventions compared with physicians in low-spending regions; however, both appear equally likely to recommend guideline-supported interventions. Greater attention should be paid to the local factors that influence physicians' clinical judgment in discretionary settings.

Practice-Based Evidence Rather Than Evidence-Based Practice in Psychiatry

Medscape Journal of Medicine June 16, 2008 Video Editorial by: Dr. David Hellerstein Associate Professor of Clinical Psychiatry Columbia University in New York. "Physicians are barraged with demands to implement evidence-based practices (EBP).[1] Hesitate and you risk being labeled as part of the medical axis of evil. Some resisters may favor "superstition-based practice." Not me. But, I do believe that the evidence that evidence-based practice works in actual practice often isn't good enough." http://journal.medscape.com/viewarticle/575578