Publications

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Reduction of Off-Label Use of Antipsychotics in a Long Term Care Facility

JAMDA
March 1, 2018
The Centers for Medicaid and Medicare Services (CMS) sets a goal for nursing homes that residents should not receive an antipsychotic medication unless absolutely necessary. One commonly-cited number is that 15.5% of long-term nursing home residents...

Reducing Falls in the Frail Elderly

JAMDA
March 1, 2018
Falls in frail elderly have been recognized by Centers for Medicare & Medicaid Services (CMS) as a focus for research to reduce morbidity, mortality, and health care costs in this population. The CDC (2016), estimates the cost of falls and...

RAVEN Initiative: Implementation of an Intervention to Reduce Antipsychotic Use in the Nursing Home Setting

JAMDA
March 1, 2018
Antipsychotic drugs are associated with serious adverse effects including an increased risk of death when used in elderly patients for the treatment of dementia-related behaviors. Despite this risk, antipsychotics remain a commonly prescribed...

Post-Acute Care RNs impact on MSSP Skilled Nursing Facilities Length of Stay

JAMDA
March 1, 2018
Baylor Scott & White Quality Alliance (BSWQA) created a Transition of Care project in the Post-Acute Care area utilizing embedded RN Care Managers in select North Texas skilled nursing facilities (SNFs) with a goal of reducing length of stay (...

Patient-centered Goals of Care: Using the Chronic Care Management (CCM) Code Towards Cooperative Goal Setting in the Multimorbid Elderly

JAMDA
March 1, 2018
Patient-centered care contributes to quality healthcare delivery by encouraging health care providers to consider patients’ needs as articulated by the patients themselves. Due to barriers such as limited time and lack of clinician training, shared...

Medical Assistance in Dying in Alberta: Implementation of a Provincial Care Coordination Service for an Unprecedented Clinical Activity

JAMDA
March 1, 2018
In June 2016 Bill C-14 was enacted by the Federal Government. This bill decriminalized the assistance of suicide, by physicians and nurse practitioners, with very detailed patient eligibility requirements. The Bill, as well, reinforced the freedom...

Is It Safe to Discontinue Holding Parameters for Anti-hypertensive Medicines in Nursing Facilities?

JAMDA
March 1, 2018
Many patients are prescribed anti-hypertensive medications with holding parameters to maintain a goal blood pressure and avoid episodes of hypotension or bradycardia in hospital. However, when these patients are discharged to nursing homes, they are...

Improving Elder Care in a Community Based Hospital

JAMDA
March 1, 2018
Older adults (65+) account for over one-third of hospital admissions, and many are at risk for hospital-related complications. Our primary focus is to implement sustainable quality improvement changes at the local hospital level to improve the...

Implementation of an Evidence-Based Inpatient Delirium Prevention Program – Real Life Barriers and Successes

JAMDA
March 1, 2018
Despite the wealth of evidence to demonstrate the success of comprehensive non-pharmacologic interventions in the prevention of delirium in hospitalized patients, at our hospital these preventative measures are not standard practice. We developed a...

High Acuity Unit in SNF: Novel Program to Improve Quality of Care for Post-Acute Patients

JAMDA
March 1, 2018
Over the past several years, the acuity level of patients discharged from the hospital to skilled nursing facilities (SNF) has increased significantly, and the role of the SNF has expanded. Increasingly, SNFs are caring for patients with higher...