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Screening for Dementia: A Podcast with Anna Chodos, Joseph Gaugler and Soo Borson

GeriPal

So we measure things like hospitalizations and ed visits and the like, and those data are a bit weaker, but they’re also, you know, I think they need to be contextualized in what, why we would even want to reduce hospitalizations right. Why would we want to? Now, we would believe this from a primary care perspective.

Screening 119
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How Doctors Can Save More and Do Less

The Motivated MD

In medicine, it is commonly agreed that ‘to err is human’ Most healthcare professionals would agree that humans make mistakes. ’ Though it often does not come with the attending salary, medical trainees are getting paid to perform a service, and hospitals provide retirement plans to these individuals.

Finance 52
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Nudges for Prognosis and Comfort Care in the ICU: Kate Courtright, Scott Halpern, & Jaspal Singh

GeriPal

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. What is sludge?

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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

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!

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RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest

GeriPal

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. Corita 09:39 Yeah, so we used the electronic health record, I think, in support.

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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

Kate: So it was an embedded alert in the electronic health record and they just clicked those two answers very quickly. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Also the same hospital system? I’m just stunned even writing that! We’ve come so far as a field. Eric: Okay. Kate: 3,500.

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Who should get Palliative Care? Kate Courtright

GeriPal

Palliative care, in contrast, saw explosive growth in US hospitals. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. That’s just not how the hospital works. Or the hospital, the intervention delivery is by who’s in practice.