Publications

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Identify, Triage, and Treat (ITT) – A Programmatic Approach to the Assessment and Treatment of Patients with Clinical Changes to Limit Readmission

JAMDA
March 1, 2017
Increasing pressure by payers to limit readmissions across the continuum of care requires all providers in post-acute care and long term care (PALTC) to be aware of opportunities to treat patients who develop acute clinical deterioration safely and...

Healthcare Team Attitudes Influencing the Use of Intravenous Furosemide in a Long Term Care Center for the Treatment of Acute Decompensated Heart Failure

JAMDA
March 1, 2017
For residents living in long term care (LTC), cardiovascular disease represents one of the broadest challenges. Included within this diagnostic category are a number of diseases such as hypertension, myocardial infarction, and ischemic stroke, with...

Glycemic Control in Long-Term Care (PALTC) Older Residents with Diabetes Mellitus: An Opportunity for Less Intensive Therapy Consistent with Current Guidelines. A Quality Improvement (QI) Project

JAMDA
March 1, 2017
Diabetes Mellitus (DM) is common in older adults in the LTC setting. AGS and AMDA updated guidelines comment on the need for individualized glycemic control. They recommend a hemoglobin A1c (A1c) generally between 7.5 and 8%; between 7 and 7.5% if...

Fluoroquinolones, You’re Fired!

JAMDA
March 1, 2017
Efforts to improve antibiotic prescribing have become essential due to increased bacterial resistance and decreased antibiotic formulation. Long term care (LTC) facilities play a unique role in antibiotic overuse, as studies have found that 47-79%...

Discontinuation of Statins in Elderly Patients with Advanced Dementia and Limited Life Expectancy

JAMDA
March 1, 2017
Statins play a major role in primary and secondary prevention of stroke and coronary artery disease. In the elderly populations, there is limited evidence regarding their efficacy and benefits. Statins can increase the risk of falls; myopathy and...

Deprescribing in the Nursing Home: Phase 1 - PRN Medications

JAMDA
March 1, 2017
Deprescribing is a relatively new concept in medicine and particularly important for older adults. While new recommendations for deprescribing of certain scheduled medication classes have been emerging, there is still a lack of deprescribing...

Collaboration Between Hospitalists and Nurse Practitioners in a Skilled Nursing Facility and Its Impact on 30 day Readmissions

JAMDA
March 1, 2017
Hospital readmission and specifically 30 day readmissions have been widely used by CMS and accepted by most hospital payers as a quality indicator. A key focus in the nursing home (NH) over the last few years has been on preventing hospitalizations...

Catch Me if You Can: A Quality Improvement Initiative to Decrease Fall Rates among Nursing Home Residents

JAMDA
March 1, 2017
Falls are prevalent among nursing home (NH) residents, with approximately 1.5 falls per NH bed-years. Most of these falls are benign but 10-25% result in hospital admission and/or fractures. 3.3% of long term care residents nationally experienced...

An Interdisciplinary Team - Developed Nursing Home Orientation as a Quality Improvement Tool in Improving Community Perceptions of Post Acute and Long Term Care Services

JAMDA
March 1, 2017
Transitioning to PA or LTC can be challenging. Patients’ and families’ as well as staff and provider perceptions play a significant role in its community evaluations. Patient, family, healthcare provider and staff support is essential in...

A Step Forward Quality

JAMDA
March 1, 2017
Diabetes management comes with challenges for patients and clinicians alike and is more common in older adults, having a high prevalence in long term care (LTC) facilities. Diabetes is associated with significant disease burden, complex management...