GeriPal

OCTOBER 13, 2022

We have a discussion about the decision to remove race, a social construct, from clinical risk calculators (though I’m not 100% sold that race should always be removed – if removal is likely to worsen disparities for example – at least until a superior race-blind calculator can be developed). One of your articles addresses that.

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Complication Patient-Centered IT Patients 97

GeriPal

MARCH 14, 2024

But estimates in community dwelling older adults are around 15%. And then when you look long-term care facilities, more between that like 35 to 50%, and then much higher estimates in hospitalized older adults. Eric: And why is it more common in hospitalized adults? What happens after they develop dysphagia in the hospital?

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IT Patient-Centered Hospital Individual 125

GeriPal

JANUARY 23, 2025

Join us as we dive deeper into these studies and discuss the implications for clinical practice and patient care. Alex 00:36 And next we have Connie Fung, who I know well through the Beeson community and is a physician, researcher, professor of medicine at UCLA. Eric 15:32 Could do this in clinical practice. Connie 14:57 Yeah.

Specialization 120

Specialization IT Patient-Centered Medical 120

GeriPal

JULY 19, 2024

Joe 03:55 You know, my thoughts are screening is important for a variety of reasons, and certainly Doctor Boris and Soo and Anna, Doctor chodos can provide a lot greater clinical insight than I. What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients.

Screening 120

Screening Primary Care Patient-Centered IT 120

PEMBlog

SEPTEMBER 24, 2024

It is believed that this sequestered portion of his lung placed him at an elevated risk for infections as this is a known complication of bronchopulmonary sequestration. Pulmonology and surgery were consulted during his hospital stay, and he has since had a left lower lobectomy after healing from his pneumonia. 2004 Nov;49(4):302-9.

Diagnosis 52

Diagnosis Diagnose Patients Asthma 52

GeriPal

MAY 19, 2022

Dr. Akhila Reddy and colleagues study looking at converting hospitalized cancer patients from IV hydromorphone to PO morphine, PO hydromorphone, or PO oxycodone. It depends on the clinical situation. I know this is like, we’re talking about math and so that makes it all a little complicated, but think about it this way.

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IT Patients Individual Relationship 139

GeriPal

JUNE 8, 2023

-@AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of life care Transcript Eric: Welcome to the GeriPal podcast. Alex Smith: That’s a compelling clinical argument… Tamryn: It is.

Diabetes 74

Diabetes Management Patient-Centered Families 74

The Clinical Problem Solvers

APRIL 5, 2022

Bobby Watts about what brought them into their fields, how their work reaches the most marginalized, and what can be done at the community and structural level to address homelessness. Know your community resources. Our guests emphasize that physicians must be familiar with community resources.

Community 52

Community Patient-Centered Emergency Room Medical 52

GeriPal

NOVEMBER 17, 2022

Assisted Living Communities (no longer preferable to call them Assisted Living Facilities, as we learned on the podcast) are…what, exactly? If you’ve seen one Assisted Living Community you’ve seen one Assisted Living Community. . If you’ve seen one Assisted Living Community you’ve seen one Assisted Living Community. .

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Community IT Mental Health Medical 97

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. Liz: Well, some aspects of this paper around clinical momentum and things around defaults and that sort of thing. Proud Mary.

Hospital 126

Hospital IT Patient-Centered Patients 126

GeriPal

FEBRUARY 15, 2024

So Carmen and Katie developed an EMS Community Partnership program. They created a seamless link between this Community Partnership program and 911 calls for falls. Eric and I enjoyed talking with Carmen and Katie about this innovative and common sense approach to addressing falls in the community. Word of mouth spread rapidly.

Community 116

Community Transportation IT PCP 116

Annals of Family Medicine

NOVEMBER 20, 2024

Context: People experiencing homelessness (PEH) and type 2 diabetes are hospitalized more often, develop diabetes complications, and die on average 10 years earlier than their housed peers due to poorly controlled chronic physical and behavioral health conditions.

Diabetes 130

Diabetes Medical Complication Physicals 130

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. In their communities? It used to be a much more complicated model. David: Right.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

NOVEMBER 14, 2024

If you want to do a deeper dive into some of the articles we discuss, take a look at the following: An awesome JAMA review by Sarah on fall risk assessment and prevention in community-dwelling adults. You know, if you want to think about the problem, think about clinical research. Eric 03:49 Great. A fall related injury.

IT 125

IT Screening Patient-Centered Community 125

GeriPal

OCTOBER 20, 2022

How HHS and ASPE solicit input from clinicians, community leaders, and older adults and how much it impacts policy decisions (spoiler alert: this involvement is CRUCIAL). There’s a team now with them behind them making sure that they stay safe and held in our communities. How to make your voice heard and get involved.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

MAY 25, 2023

Sarah Nouri, Hillary Lum, and LJ Van Scoy argue that diverse communities are asking for ACP. Sarah Nouri gives an example from her work in the LGBTQ+ community of a trans woman who was buried as a man because existing laws/rules did not protect her wishes. Complicated grief? Did the caregiver feel heard and understood?

Community 96

Community IT Patient-Centered Primary Care 96

GeriPal

SEPTEMBER 7, 2023

Based on this surge in evidence, the American Society of Clinical Oncologists recently updated their guidelines for care of older adults to state that all older adults receiving systemic therapy (including chemo, immuno, targeted, hormonal therapy) should receive geriatric assessment guided care. Mazie, welcome to GeriPal. William: Sure.

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Patient-Centered IT Patients Clinic 130

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Why this study was a success due to the sheer size (nearly 100,000 patients in about 30 EDs) of the study, and the fact that, as far as the investigators know, all study sites continue to employ the clinical decision support tool.

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Patient-Centered IT Hospital Patients 78

GeriPal

OCTOBER 26, 2023

Summary Transcript Summary Often podcasts meet clinical reality. But rarely does the podcast and clinical reality meet in the same day. Alex: And Sarguni Singh, who’s a hospitalist researcher, Assistant Professor of medicine in the division of Hospital Medicine at the University of Colorado. Ann: Thank you.

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Patient-Centered Hospital Patients IT 133

GeriPal

FEBRUARY 23, 2023

Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? ” and the answer is no, that probably was more just about do you need anybody to support you kind of emotionally or during this hospital stay, just give information to.

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Family Families Patient-Centered IT 98

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay.

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. And she was rushed to the hospital. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MARCH 28, 2024

Ten years ago we would have been hard pressed to find 3 clinical trial abstracts submitted to the annual meeting, much less high quality randomized trials with robust measures, sample sizes, and analytics plans. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Also the same hospital system?

Consulting 116

Consulting Patient-Centered IT Patients 116

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. So at least in my oncology community, I really didn’t have anyone guiding or supporting or mentoring me. They all self-identified as a hospital based practice.

Illness 111

Illness Hospital Patient-Centered Patients 111

PEMBlog

JUNE 2, 2025

Clinical Case You are a senior resident working in the busy emergency department on an overnight shift. Hypertensive emergency is a clinical diagnosis characterized by a sudden and severe elevation in blood pressure accompanied by signs of acute end-organ dysfunction. Look for the underlying cause renal disease leads the list in kids.

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Hypertension Management Physicals Lab Testing 75

GeriPal

JULY 21, 2022

I don’t practice clinically in outpatient settings, and often the folks I’m seeing are there for other kinds of issues. I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury.

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IT Families Family Diagnosis 102

GeriPal

MAY 26, 2022

Another area where this came up that I think has to just be clearly reciprocity is that people who were volunteers or clinical trial participants were often prioritized to some extent for COVID 19 vaccines. And on the prioritization front, I think we ended up being pretty skeptical.

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Vaccination Individual IT Healthcare 88

GeriPal

JANUARY 26, 2023

Can you give us some examples, even the ones you mentioned in the paper, about how some of these structural races, like these common things that may occur in the hospital or in the clinics that we use, and we may not even think about? You go into this community, perform this study, you leave. Eric: Six months ago. Eric: Yes.

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IT Patient-Centered Healthcare Patients 92

GeriPal

FEBRUARY 13, 2025

We covered some of our questions on the podcast, others you can ponder on your own or in your journal clubs, including: Maries tele/video palliative care intervention was tailored/refined with the help of a community advisory board. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. Was it Sarah?

Consulting 64

Consulting Community Patient-Centered Families 64

GeriPal

MAY 22, 2025

When we started doing more music stuff for our patients in the hospital, a lot of people started to think, hmm, what would I want to listen to? So our inpatient hospitals are kind of under resourced for music therapy. It’s something that has no place in a hospital in most people’s thinking. Tyler 01:43 Okay.

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IT Patient-Centered Patients Board-Certified 98

GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

MAY 4, 2023

We talk about why it’s so hard with Abby Rosenberg (chief of PC at DFCI and Boston Childrens), Nick Purol (clinical social worker at DFCI and Boston Childrens), Daniel Eison (pediatric PC doc and co-host of PediPal). Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues.

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IT Families Family Illness 83

GeriPal

MARCH 30, 2023

Then I got online as a patient advocate and started connecting with the brain tumor community on social media and Facebook and Twitter, and actually started working in the healthcare space, in palliative care advocacy, for a palliative care advocacy organization in California, which is where I’m based, about eight years ago.

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IT Patient-Centered Patients Healthcare 96

GeriPal

AUGUST 25, 2022

And yet, we know little about the clinical experience of people with dementia in hospice. For-profit hospices having much higher rates of their patients visiting the emergency department and being hospitalized, in addition to disenrollment. Because people, they go to the hospital, then they revoke. What motivated you?

Families 107

Families Family IT Patients 107

GeriPal

MARCH 24, 2022

Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences. I know not all systems are set up to allow for that or facilitate that retrieval, which makes things a little bit more complicated when push comes to shove.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

Patient-Centered 96

Patient-Centered Patients IT Illness 96

GeriPal

JANUARY 11, 2024

Alex: We’re delighted to welcome Leonie Herx, who’s a palliative care physician and clinical professor at the University of Calgary. So we’re going to be talking about this complicated topic that a lot of people have differing opinions to and potentially very strong opinions, medical aid in dying. Bill: Thank you.

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Illness IT Medical Provider 144