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

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 120

Specialization IT Patient-Centered Medical 120

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 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. .

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 72

Vaccination Medical Student Patient-Centered Community 72

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. And yet, after assisting the older adult to their feet, the EMS providers would leave. So Carmen and Katie developed an EMS Community Partnership program.

Community 116

Community Transportation IT PCP 116

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. Eric: What kind of differences did you see?

Hospital 126

Hospital IT Patient-Centered Patients 126

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? With their regular providers? AMA PRA Category 1 credit(s) ™.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

NOVEMBER 14, 2024

Summary Transcript CME Summary Falls are very common among older adults but often go unreported or untreated by healthcare providers. Providers may feel a sense of nihilism, that there just isn’t anything they can do to decrease the risk of falling. I think providers feel that way. There may be lots of reasons behind this.

IT 125

IT Screening Patient-Centered Community 125

GeriPal

OCTOBER 20, 2022

This office is tasked with providing aging policy research and recommendations within ASPE, including long term care and the National Alzheimer’s Project Act. 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).

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. I provide information about the risks, side effects, costs, and potential benefits. Often medication is useful to better control these conditions and help reduce these risks.

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

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 133

Patient-Centered Hospital Patients IT 133

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?

IT 102

IT Families Family Diagnosis 102

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

APRIL 10, 2025

Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it. 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. hospice use).

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

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 so the family is there in much more of an advisory role rather than providing say, cognitive scaffolding that they might provide in supported decision making.

Family 98

Family Families Patient-Centered IT 98

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 116

Community IT Relationship Healthcare 116

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. His story, which he shares on todays podcast, is remarkable.

Healthcare 102

Healthcare IT Community Illness 102

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

PEMBlog

JUNE 2, 2025

Before your blood pressure rises as well, know that this PEMBlog article is here to provide an overview of the recognition and management of hypertensive emergencies. References: Bertazza Partigiani N, Spagnol R, Di Michele L, et al.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

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

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable. Eric: Yeah.

IT 83

IT Families Family Illness 83

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 130

Patient-Centered IT Patients Clinic 130

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.

IT 98

IT Patient-Centered Patients Board-Certified 98

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

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

AUGUST 25, 2022

For-profit hospices having much higher rates of their patients visiting the emergency department and being hospitalized, in addition to disenrollment. I think that there are some really great for-profit hospices out there that are actually able to provide more services and more open access for patients.

Families 107

Families Family IT Patients 107

GeriPal

MARCH 28, 2024

Kate: The problem is we communicate late, we share prognosis late, we elicit goals and values late, so all the time while they’re in the ICU getting prolonged intensive care, we don’t really know that we’re providing goal concordant care, so we wanted to nudge it a little upstream. Also the same hospital system?

Consulting 116

Consulting Patient-Centered IT Patients 116

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

MARCH 30, 2023

This week we’ve invited three guests to share their stories about storytelling that’s written for healthcare providers. Then in the OpenNotes work that I do, I was hired to take something complicated like transparency and patients having access to their full records in medicine, and then making that something that the lay public understood.

IT 96

IT Patient-Centered Patients Healthcare 96

GeriPal

JANUARY 11, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

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

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