GeriPal

MAY 5, 2022

We talk with Nick and Meg about: Why hearing loss is important not just in geriatrics but also for those caring for seriously ill individuals. Communication techniques we can use when talking to individuals with hearing loss. But individuals who have hearing loss, there’s several problems. How to screen for hearing loss.

IT 102

IT Screening Hospital Clinic 102

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 Education Relationship 52

GeriPal

OCTOBER 13, 2022

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. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control. Diff rates, for example at a unit level.

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 then again, individualizing it to the patient. Eric: Drew, both of our fourth step is individualizing it. Pallimed post on “ Simplifying Opioid Conversions ”.

IT 139

IT Patients Individual Relationship 139

GeriPal

JUNE 8, 2023

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. So I’m more familiar with patients who develop diabetes after treatment, but I’m really interested in learning about patients that Nadine cares for.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JULY 19, 2024

What should we use to screen individuals? 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. Who should get it if anyone?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

NOVEMBER 9, 2023

If you’re going to be talking to the brand new intern on the service, or the chief executive of the hospital, are there some themes or similarities to how you’d approach that in the mentoring, sorry, not the mentoring, the coaching process? Beth: Yeah. Eric: Well, Greg, are there themes? I got to get my terms right.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

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

The Motivated MD

SEPTEMBER 19, 2024

For the better half of 2024, I have been periodically writing posts that are individual articles that double as potential chapters to a future book. Before we discuss each individual savings account, let us first highlight exactly what it means to ‘automate’ your savings. So yes, humans make mistakes.

Finance 52

Finance Education Individual Healthcare Professional 52

GeriPal

JUNE 12, 2025

I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. Sometimes individuals have lung tumors that make it difficult for them to breathe. But radiation oncology was really more or less like a black box.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

FEBRUARY 15, 2024

So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. I was like, “I have all these things I’m doing in the hospital to try to make people better and then I might be sending them right back to a big hazardous environment.” Eric: Oh, no.

Community 114

Community Transportation IT PCP 114

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. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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? Alex: Yeah.

Family 102

Family Families IT Diagnosis 102

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. But we’re not perfect individuals.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

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. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

SEPTEMBER 12, 2024

Ishwaria 05:29 And that’s really how this field of professional well being, healthcare professional well being, clinician well being, has evolved, is that there is an important place in our overall professional well being for personal resilience and our individual coping strategies, recovery methods from day to day.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

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 97

Family Families Patient-Centered IT 97

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

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?” Within the VA it’s now at 70 VA hospitals.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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. Jennifer: They have a meaningful impact on what happens to them during the hospitalization and after. They all self-identified as a hospital based practice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

APRIL 3, 2025

Annie 02:31 So if you go to the A G S meeting every year, you know that this group of three individuals comprises the AGS literature update. But in spite of that, it is a lot of work for three individuals to pull all this together. So that this is not something that might affect the individual clinician patient decision.

IT 64

IT Hospital Screening Patients 64

GeriPal

NOVEMBER 14, 2024

Sarah 11:14 So it’s really assessing patients for their individual risk factors for falls. I think there’s a few studies in dialysis patients and in hospitalized patients suggesting that gabapentin and pregabalin is associated with an increased risk of falls. Eric 11:10 And tell me, what is a multifactorial intervention?

IT 124

IT Screening Patient-Centered Community 124

GeriPal

OCTOBER 20, 2022

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. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control. Diff rates, for example at a unit level.

Complication 52

Complication Patient-Centered IT Patients 52

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

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. Was the clinician working frontline in those community hospitals? hospice use).

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

GeriPal

MARCH 2, 2023

Eric: And we have Tasce Bongiovanni, who is an acute care trauma surgeon at UCSF and the San Francisco General Hospital. I also heard that if you look at all individuals in the US, about 4% of individuals are taking one of the gabapentinoids, 10% over 65. Welcome to the GeriPal podcast, Nisha. Nisha: Thank you so much.

Patient-Centered 96

Patient-Centered IT Healthcare Medical 96

GeriPal

DECEMBER 15, 2022

Been in the hospital four times, vented, been told the story to her family, she won’t live. Within the VA it’s now at 70 VA hospitals. It started here at Madison at one and it’s also spread outside the VA now to hospitals in Boston, Providence and now starting up actually in California and UCLA and UCSF.

IT 105

IT Patient-Centered Healthcare Illness 105

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

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

Doctor On Demand

APRIL 28, 2025

In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals. Paramedics can provide life-saving treatment on the way to the hospital.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

APRIL 4, 2024

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

Family 112

Family Families Patient-Centered IT 112

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 126

Patient-Centered IT Patients Illness 126

BMJ

MAY 10, 2022

Family physicians and family health workers, considered reliable sources of vaccine information, have a unique position where individuals in rural and urban areas can access frequently, uninterruptedly, cheaply, and easily [2]. Two hundred seventy-six of the healthcare professionals were reached (response rate: 85.4%).

Vaccination 40

Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Gordon 41:13 The hospital is also on fire. I want you to be able to be in the hospital and be with your loved one. Eric 41:08 Wait, wait, hold on.

IT 132

IT Illness Family Families 132

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. Sue 01:26 Thank you.

IT 104

IT Patient-Centered Family Families 104

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. And the nurse can’t dose it, they have to individually dose it.

Illness 136

Illness Patient-Centered Screening Clinic 136