The Clinical Problem Solvers

FEBRUARY 9, 2020

With the help of the #MedTwitter community, we have started a list of helpful LRs at the bottom of this article that we hope serves as a foundation for you to build on! On hospital day #2, peritoneal fluid cultures returned positive for E. Furthermore, creating a list of the LRs for useful diagnostic tests in common diseases (e.g.,

Clinic 52

Clinic Diagnosis Hypertension Patients 52

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?

IT 124

IT Patient-Centered Hospital Individual 124

PEMBlog

AUGUST 20, 2024

ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. The episode highlights the importance of understanding eCPR as a critical therapy for both in-hospital and out-of-hospital cardiac arrests.

Patient-Centered 52

Patient-Centered Hospital Patients IT 52

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

JANUARY 23, 2025

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. I’m an internist, so when I hospitalize patients, 1 in 8 of my patients now takes pregabalin or gabapentin. Maybe even had come in with a complication. 1 in 8 in the U.S.

Specialization 119

Specialization IT Patient-Centered Medical 119

GeriPal

JULY 19, 2024

But the thing that really motivates me is seeing, you know, and trying to manage later stage, you know, we can call them complications of people who haven’t had a diagnosis are now really in, you know, a world of complexity around other conditions, around managing life and managing practical things. Why would we want to?

Screening 119

Screening Primary Care Patient-Centered IT 119

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. 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. So, there’s no big differences.

IT 139

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. This is Eric Widera. Alex Smith: This is Alex Smith. Is that your experience?

Diabetes 74

Diabetes Management Patient-Centered Family 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

Annals of Family Medicine

NOVEMBER 20, 2024

We excluded deliveries complicated by known RFs for PTB (n=12,646). Conclusions: Rural residence was a RF for sPTB in this Iowa community. Setting: IHC, Iowa City, IA. Population Studied: We started with 29,620 deliveries at IHC between May 1, 2009, and May 31, 2023. The final dataset included 16,974 deliveries among 13,339 mothers.

Insurance 130

Insurance Complication Relationship Community 130

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. .

Community 97

Community IT Mental Health Medical 97

Doctors for America

MAY 30, 2025

COVID-19 infection continues to result in hundreds of thousands of hospitalizations annually, and causes the deaths of hundreds of Americans each week. Millions of Americans continue to live with complications of this disease and long COVID. We need all tools available to prevent complications of COVID-19.

Vaccination 73

Vaccination Medical Student Patient-Centered Community 73

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. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though.

Hospital 125

Hospital IT Patient-Centered Patients 125

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 115

Community Transportation IT PCP 115

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

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. Sarah 03:57 Yeah, it’s a pretty big problem for older adults, I’d say in community dwellers. It’s one out of two.

IT 124

IT Patient-Centered Screening Community 124

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 122

Patient-Centered IT Illness Patients 122

Physician's Weekly

JUNE 23, 2025

It will support one to three projects that focus on tracking and understanding health issues in the community, CNN reported. Allison also praised the decision to involve the community in shaping the research. She called the NIH news “a complicated mix of emotions,” CNN said. “We We desperately need real medical support.”

Community 52

Community Asthma Engineering Complication 52

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

Vida Family Medicine

MARCH 28, 2024

Diabetes, cardiovascular disease, and metabolic associated fatty liver disease all have the potential to cause life-altering complications and premature death. That said, throughout my training I have witnessed and become experienced in treating the health consequences associated with metabolic syndrome.

Diabetes 52

Diabetes Primary Care Physician Medical 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

MAY 12, 2022

Prognosis communication and the subtle ways we may communicate it without intention. Community-based palliative care networks . I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission.

Community 115

Community IT Relationship Healthcare 115

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 117

Patient-Centered Hospital IT Illness 117

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. hospice use). Tammie 02:56 It usually doesn’t work no matter what. Corita 04:32 Yep.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

OCTOBER 26, 2023

Today we talk with Sarguni Singh, hospitalist-researcher at the University of Colorado, Ann Henshaw, Occupational Therapist who teaches at George Washington and works clinically at Georgetown, and Tamra Keeney, Physical Therapist-researcher at Mass General Hospital and Harvard Medical School. Tamra, welcome to the GeriPal podcast.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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

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.

Family 98

Family Families Patient-Centered IT 98

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 110

Illness Hospital Patient-Centered Patients 110

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. Michael’s Hospital in the Department of Family and Community Medicine. The social determinants of health and what community well being was a big part of. And this is really traumatic event for his street family and the street community that he knew.

Healthcare 100

Healthcare IT Community Illness 100

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 63

Consulting Community Patient-Centered Family 63

GeriPal

JULY 21, 2022

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. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Emmy: About 25%.

IT 102

IT Family Families Diagnosis 102

GeriPal

SEPTEMBER 7, 2023

Alex and I did a study on over 2000 community dwelling older adults, and we found that over two thirds of people had geriatric conditions, these geriatric syndromes, and palliative care related problems like pain, difficulty climbing stairs. One of my good friends, Jerome Kim, is a community oncologist. Throw it in the trash.”

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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.

IT 97

IT Patient-Centered Patients Board-Certified 97

PEMBlog

JUNE 2, 2025

Imaging and other diagnostic studies can consist of chest x-ray, EKG, renal ultrasound with doppler, voiding cystourethrography, renal arteriography, echocardiogram, and MRI/MRA/CT of the brain/neck if neurologic complications are involved (Kamat 2024; Patel 2012).

Hypertension 75

Hypertension Management Physicals Lab Testing 75

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.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

MAY 26, 2022

Emily: And so even in the pandemic, we’ve seen circumstances like this where hospitals wrote allocation policies that were going to give preference to frontline healthcare workers in hopes, right, that they would incentivize them to stay on the job knowing that they would be taken care of and because they had been working for the public good.

Vaccination 88

Vaccination Individual IT Healthcare 88

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 115

Consulting Patient-Centered IT Patients 115