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.

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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 Individual Education 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.

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Patient-Centered Referral Patients IT 102

GeriPal

FEBRUARY 20, 2025

Thats my main take-home point after learning from our three guests today when talking about trauma-informed care, an approach that highlights key principles including safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity. Eric 00:15 And we have three guests to help us talk about trauma informed care.

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IT Patient-Centered Screening Patients 66

GeriPal

FEBRUARY 15, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. 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. They may not think to ask or provide that information.

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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.

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IT Family Families Diagnosis 102

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? The supporter might offer note-taking or they might come and help with interpreting information or they might help in doing some comparative reasoning exercises. This is Eric Widera.

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Families Family Patient-Centered IT 97

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?

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Patient-Centered IT Patients Healthcare 109

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.

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Patient-Centered Hospital Patients IT 132

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. And one of the hardest things is to distill it down to a sentence or two about what is information, what does it mean? And then be quiet and listen.

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IT Illness Family Families 132

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.

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Primary Care Patient-Centered IT Patients 113

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

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?

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Vaccination Individual IT Healthcare 87

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.

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IT Healthcare Healthcare Professional Patient-Centered 110

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. ABIM MOC credit will be offered to subscribers in November, 2024.

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Illness Patient-Centered Screening IT 136

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.

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Family Families Patient-Centered IT 112

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

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.

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ER Telehealth Primary Care Doctor Appointment 52

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

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.

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IT Hospital Screening Patients 64

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. We discuss the principles of harm reduction, social determinants of health, and trauma informed care. link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. those experiencing homelessness).

Healthcare 100

Healthcare IT Community Illness 100

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

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?

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IT Screening Patient-Centered Community 124

GeriPal

MARCH 28, 2024

We all, when bombarded with information have to take certain elements of a decision and focus on those; and in the ICU, you can imagine, we’re bombarded with information a lot. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Also the same hospital system? Eric: Okay. Kate: 3,500.

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Consulting Patient-Centered IT Patients 115

GeriPal

JUNE 9, 2022

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.

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Consulting Patient-Centered Diagnosis Referral 99

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

GeriPal

MAY 25, 2023

Sarah: Yeah I similarly feel like, you know, focusing more on the process, the qualitative kind of from a research standpoint, the qualitative information that we’re getting from folks. Health care system drives where you end up, which hospital, which state you live in. Hillary or Sarah. Thoughts on that.

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Community IT Patient-Centered Primary Care 95

GeriPal

OCTOBER 5, 2023

And I have gone through my not-so-long career, but it’s coming up on nine years now, seeing the way that we have talked about CPR in such problematic ways, in ways that really do not enable true informed consent. I would say most of the time we offer CRT in the hospital. This is Eric Widera. Alex: This is Alex Smith.

Illness 136

Illness IT Patient-Centered Family 136

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%).

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Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

NOVEMBER 7, 2024

Additional link to study with heatmaps of specific locations (hospital, nursing home, home) after initiating dialysis. -@AlexSmithMD ** NOTE: To claim CME credit for this episode, click here ** Transcript Eric 00:11 Welcome to the GeriPal podcast. He would go home, and then three weeks later he would be back in the hospital.

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Management Patient-Centered Patients IT 116

GeriPal

MAY 9, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. It was about me talking about what happens about six months, when you have six months or less to live, the general information of what people usually look like. Alex: Not frequently, no.

Education 127

Education IT Illness Healthcare 127

GeriPal

JULY 11, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. I’m embedded in the ICU in one of our smaller hospitals. So I go between.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

MAY 18, 2023

So the intention of the AGS Beers Criteria is to provide information primarily to clinicians, although to other audience as well, but medications that we consider to be potentially inappropriate in older adults. Todd: There are some studies that’ll show decreased readmission if they’re stopped in hospital. Mike: Thank you.

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Medical IT Patients Clinic 97

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.

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IT Family Families Illness 83

GeriPal

JANUARY 30, 2025

But we do have the information about referrals to other ancillary providers as part of that multidisciplinary team. Lynn 37:39 I was in the hospital. But it really does need some individualizing. And also on those forms, we do know, I mean, that part wasn’t in the supplement, unfortunately. So it matters. Joe 41:30 Yeah.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

FEBRUARY 13, 2025

Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. And then we incorporated that information into the consultation process.

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Consulting Community Patient-Centered Family 63