GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

MAY 18, 2023

Alex: And we’re delighted to welcome Todd Semla, who is a clinical pharmacist and associate professor at the Feinberg School of Medicine at Northwestern University. So in those clinical situations, you should consider avoiding that drug. You have to take that into consideration clinically. Todd: Thank you.

Medical 97

Medical IT Patients Clinic 97

GeriPal

NOVEMBER 7, 2024

And the main topic of today is a paper in Annals of Internal Medicine , Maria first author, that addressed the tradeoffs between initiating dialysis vs continued medical/supportive management. Clinical experience. So we created these heat maps where you could see for each individual what actually happened in the days and you.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

DECEMBER 8, 2022

And now my program of research is around testing that person-centered narrative intervention or PCNI because you have to give them an acronym in healthcare. So we have community volunteers who often they have a background in writing or background in healthcare, certainly an interest in interviewing and an interest in writing.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

FEBRUARY 20, 2025

We also explored several questions with them, including how to define trauma, its prevalence in older adults, the impact of past traumatic experiences, the potential triggers of trauma screening, and the application of trauma-informed principles in clinical practice. Some of them are really deeply individual experiences.

Patient-Centered 66

Patient-Centered IT Screening Patients 66

GeriPal

DECEMBER 15, 2022

And now my program of research is around testing that person-centered narrative intervention or PCNI because you have to give them an acronym in healthcare. So we have community volunteers who often they have a background in writing or background in healthcare, certainly an interest in interviewing and an interest in writing.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

APRIL 10, 2025

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. And then we had clinical decision support. What is a clinical decision support? Long overdue.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

GeriPal

AUGUST 24, 2023

Just an extraordinary cast of individuals who were really so incredibly inspiring. And then the final category, the third category is what we called the dignity conserving repertoire, which really has to do with kind of the spiritual, and psychological landscape and makeup of that individual. I mean, I was very much a clinician.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

DECEMBER 14, 2023

Similarly Jessica Zitter, an intensivist and palliative care doctor analogized the inevitable clinical momentum toward highly aggressive intensive care in US hospitals as a conveyor belt. Liz: Well, some aspects of this paper around clinical momentum and things around defaults and that sort of thing. Liz: I do, indeed. Proud Mary.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

MAY 15, 2025

This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. We did another nudging trial where the deep default was for default palliative care consultations for high risk patients, and it significantly increased individuals who were receiving palliative care. Prior-auth forms?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

MARCH 3, 2022

And Lauren Ferrante has found in a study published in JAMA Internal Medicine that trajectories of disability in the year prior to ICU admission were highly predictive of disability post-ICU, on the same order of magnitude as mechanical ventilation. It was this slow build, I would say. So, that part was not surprising.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

MAY 29, 2025

And I think this just hasn’t made it into, like, our academic clinical training space. So I think the examples that we’ve seen is an individual will all of a sudden start using humor in a particular way or will using wry humor and that is reminiscent of the kind of humor the person used prior to developing dementia.

Family 93

Family Families IT Patient-Centered 93

GeriPal

MARCH 10, 2022

Now when I say variation, I’m not talking about small little clinically questionable variations. Archives of Internal Medicine 2010. One of them is Karen Steinhauser’s Annals of Internal Medicine paper on, In Search of a Good Death. Joan: A lot of my work comes out of my clinical practice.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. Eric 06:58 It could be CPR in an individual with metastatic cancer in the icu. And in addition, my work in palliative care, I also am a clinical ethicist. Ivermectin to treat cancer.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

OCTOBER 3, 2024

How the act of drawing can help us sloooow down, pay attention to the people and world around us, and ultimately let go… The possibility of incorporating drawings in research and even clinical care. I cracked myself in my head of these individuals. She has illustrations of clinician moral distress and coping. Did anybody ask for them?

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

FEBRUARY 13, 2025

And so we worked closely with a community advisory group who, through focus groups, told us how it was that black and white individuals with serious illness had wanted to be treated. The black individuals wanted to have a separate one from the white individuals. So their caregivers did focus groups. Our consultation.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MARCH 31, 2022

And you can just think about them as this… Often in medicine these days we’re come to think of our work, for some people as a conveyor belt, just one after another. So all of that, the language dimension of clinical work is, it seems to me very much more fine tuned or refined. It’s more of a precision instrument.

IT 70

IT Patients Medical Illness 70

GeriPal

JULY 6, 2023

I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse. Eric: Which is, so let’s say I am a provider, a healthcare provider taking, let’s say a nurse practitioner working in an older, a clinic that’s mainly caring for older adults.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 25, 2024

Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. Eric 07:03 And those classic studies, were those done in the hospital and PALP care units and clinic? The folks that we were seeing either in clinic or inpatient, were probably a lot sicker than the ones that we’re seeing now.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. At a high level to sort of step in and start, you know, tinkering with workflows that, you know, are kind of as healthcare is a giant machine in primary care. We did it by the clinic level.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

AUGUST 1, 2024

Anna Pleet is an internal medicine resident at Allegheny Health Network who has a collection of amazing YouTube videos on aging and the Mediterranean diet. Elizabeth Eckstrom is a geriatrician, professor of medicine at OHSU, and author of a new book, the Gift of Aging. Eric 18:14 Elizabeth, how do you bring it up in your clinic?

IT 116

IT Diabetes Chronic Disease Patient-Centered 116

GeriPal

DECEMBER 21, 2023

Malaz: One day I was in internal medicine residency and I had to take care of a patient who was admitted from a nursing home with dementia. So IU, we have been able to convert our paper, Chris Callahan paper that was published in 2006, the first clinical trial that was positive. Malaz: 1999, my friend. And I was terrified.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

DECEMBER 12, 2024

Ill end this intro with a quote from Deb Grady in an editors commentary to our thought piece in JAMA Internal Medicine about this topic: Voice technology that creates a searchable database of patients every encounter with a health care professional? Does this issue ring true to you clinically? Jenny 01:27 Thanks.

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108