The Clinical Problem Solvers

AUGUST 25, 2020

Pearls Defining Structural Racism Structural racism is a term that acknowledges that racism is perpetuated beyond individual interactions and interpersonal racism, but is present in the systems and policies that govern our everyday lives.

Community 52

Community Patient-Centered Relationship Education 52

GeriPal

OCTOBER 13, 2022

There’s a team now with them behind them making sure that they stay safe and held in our communities. And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. Lona: Absolutely. Eric: Can I touch on the last study?

Complication 97

Complication Patient-Centered IT Patients 97

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. And really, the best that had ever been looked at, especially in our population and sort of a cancer serious illness population. Landmark study. And yes, I do believe in that.

IT 139

IT Patients Individual Relationship 139

GeriPal

JUNE 8, 2023

Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? And my hypothesis is that’s because it’s no longer the individual managing their own diabetes, it’s the nursing home staff managing their diabetes. Listen in to learn more!

Diabetes 74

Diabetes Management Patient-Centered Families 74

GeriPal

MAY 8, 2025

We’ll discuss three recent clinical trials involving patients with serious illness, joined by our guests James Downar , Ali John Zarrabi , and Margaret Ross. We’re going to be talking about new research in psilocybin in serious illness. Vincent’s Hospital in Melbourne, Australia. This is Eric Widera.

Illness 109

Illness IT Patient-Centered Patients 109

The Clinical Problem Solvers

MAY 2, 2022

Dr. Valtis is a 4th year Med-Peds Resident at Brigham & Women’s Hospital and Boston Children’s Hospital, and his research focuses on race and the utilization of security responses in the inpatient hospital setting. Yannis Valtis, Ebi Okah, and Carine Davila, about research in their respective fields. Calac, Victor A.

Healthcare 52

Healthcare Utilities Hospital Internal Medicine 52

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 126

Hospital IT Patient-Centered Patients 126

GeriPal

AUGUST 31, 2023

Summary Transcript Summary How do people react when they hear they have a serious illness? And some people, in addition or instead, engage in deep introspection on how to make meaning or live with or understand this experience of serious illness. Shock, “like a car is rushing straight at me” (says Bill Gardner on our podcast).

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Illness IT Diagnose Medical 129

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. In their communities? The article we discuss today, also published in JAMA , addresses these two gaps. With their regular providers?

Patient-Centered 123

Patient-Centered IT Illness Patients 123

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. I would like to request the Friendship Train by Gladys Knight and the Pips.

Community 96

Community IT Patient-Centered Primary Care 96

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Additional links: Editorial on Areej’s study. Palliative care in lung and GI cancers. Transcript.

Illness 111

Illness Hospital Patient-Centered Patients 111

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Bennett, C.R., Schilling, L., Doorenbos, A. PMID: 26701962.

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Patient-Centered Illness Healthcare IT 116

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. Participants were critically ill and intubated. What is sludge? What to make of that?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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

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.

Families 98

Families Family Patient-Centered IT 98

GeriPal

SEPTEMBER 21, 2023

Feyron has centered her work in Black/African American faith communities and churches – a program she titled Alter. Alex: And we’re delighted to welcome Fayron Epps, who is associate professor and director of Community and Research Engagement at the School of Nursing at Emory. Why this focus? Karen: Thank you. Alex: Great.

Community 129

Community Families Family IT 129

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. those experiencing homelessness).

Healthcare 102

Healthcare IT Community Illness 102

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

JULY 21, 2022

Love to talk about also in the serious illness population. 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. Eric: Well, Terri and Emmy, thank you for joining on this podcast.

Families 102

Families IT Family Diagnosis 102

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

DECEMBER 15, 2022

So during the dissertation, that was a method for my PhD research and that’s related to… I was learning about African American elders experiences of psych-social-spiritual healing and serious illness. Been in the hospital four times, vented, been told the story to her family, she won’t live.

IT 106

IT Patient-Centered Healthcare Illness 106

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.

IT 83

IT Families Family Illness 83

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! Good to know.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. Eric 00:51 So we’re gonna be talking about caring for people with serious illness and substance abuse. Who has a song request for Alex before we talk about substance use disorder and serious illness?

Patients 74

Patients Clinic Patient-Centered Illness 74

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? 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.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

GeriPal

JUNE 30, 2022

Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. And she was rushed to the hospital. Did I get that right? Joel: Oh yeah.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. So less than six months to live.

Illness 144

Illness IT Medical Provider 144

GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. So we are going to leapfrog over the healthcare system education and we’re going to go straight to the citizens of the world and we’re going to give them the insider tips to how to improve their illness experience.”

Education 128

Education IT Illness Healthcare 128

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. They didn’t feel connected to the people in their broader community.

IT 100

IT Community Patient-Centered Medical 100

GeriPal

MARCH 24, 2022

Then listen to these prior podcasts with Sean Morrison and Rebecca Sudore about this issue, and we recently discussed differences between Advance Care Planning and Serious Illness Communication with Juliet Jacobsen and Rachelle Bernacki. . Where does POLST fit in with this debate? This is Eric Widera. Alex: This is Alex Smith.

Illness 73

Illness IT Healthcare Patient-Centered 73

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

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended? Yael 30:29 Exactly.

Patient-Centered 110

Patient-Centered IT Patients Healthcare 110

GeriPal

JUNE 22, 2023

And then from that, through community activists, ACT UP, legislators who felt that there needed to be something done, doctors within CDCR who cared passionately about the HIV population and others, all came together and we were able to eventually get funding for this 17-bed inpatient hospice. It’s by choice, just like in the community.

Families 133

Families Family IT Community 133

GeriPal

JANUARY 30, 2025

We really spent a lot of time helping the clinicians see that a patient’s illness, understanding and prognostic awareness was just as important as their pain scale, their pain score. The patient refuses to ever talk about the fact that this illness could take their life. Lynn 37:39 I was in the hospital.

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Telehealth Patient-Centered IT Patients 106

GeriPal

MARCH 24, 2023

Usually I don’t put a lot of background on this podcast, but I got to … in November of 2022, Ava Kofman, along with ProPublica, published … well I won’t want to say great, published an article in The New Yorker that I think it was divisive in the hospice and palliative care community. Eric: Great. Now it’s 70%.

IT 115

IT Provider Patients Families 115

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 116

Consulting Patient-Centered Patients IT 116

GeriPal

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. We need to figure out how to create this community of palliative care social work scholars. Eric: Yeah.

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IT Families Family Clinic 102