Recommendations of Inpatient Geriatrics Consultation

描述（由申请人提供）：迈克尔·韦纳，医学博士，公共卫生硕士，是一名获得委员会认证，接受过奖学金培训的内科医生。作为印第安纳大学（IU）医学部普通内科和老年病学部门的助理教授，以及印第安纳大学卫生保健研究所（RIHC）和印第安纳大学老龄化研究中心（IUCAR）的科学家，他现在将70%的专业时间用于研究。他在信息系统方面有广泛的背景，他使用过大型数据库，研究过信息系统对医疗保健的影响。韦纳博士35个月的教学工作取得了成功，因为他的才能和训练以及他丰富的环境。印第安纳大学医学院照顾大量老年患者

DESCRIPTION (provided by applicant): Michael Weiner, MD, MPH is a board-certified, fellowship-trained internist. As Assistant Professor in the Division of General Internal Medicine and Geriatrics in the Department of Medicine at Indiana University (IU) and Scientist in The Regenstrief Institute for Health Care (RIHC) and the IU Center for Aging Research (IUCAR), he now spends 70% of his professional time in research. He has an extensive background in information systems, and he has used large databases and studied the impact of information systems in healthcare. Dr. Weiner's 35 months on faculty have been successful because of his talents and training as well his rich environment. The IU School of Medicine Faculty care for a large population of older patients in a state-of-the-art clinical laboratory. Clement J McDonald, MD developed one of the world's largest and most comprehensive medical records systems on site. Christopher M. Callahan, MD is founding director of IUCAR, whose primary research themes are health promotion and the management of chronic conditions among older adults in primary care and community settings. Steven R. Counsell, MD is Director of Geriatrics at IU. Dr. Weiner seeks to pursue a research career focusing on improving coordination and quality of care for older adults. The goal of this proposal is to help Dr. Weiner bridge the gap between his early intramural support and eventual extramural funding as an independent faculty researcher. Dr. Callahan will be the primary mentor, and Drs. McDonald and Counsell will be the secondary mentors. Dr. Weiner will also pursue formal training in clinical geriatrics, quality of health care, behavior change, and clinical trials. Geriatrics consultants provide a team approach and coordination of many services for hospitalized older patients, but the consultants' effectiveness is limited by primary-care physicians' failures to adopt most recommendations. In the proposed study, we seek to measure and improve aspects of implementation of consultants' recommendations. The specific aims of this proposal are to conduct a prospective study of inpatient geriatrics consultation, to identify specific determinants of implementation; present findings and themes to focus groups of physicians and patients, to generate consensus on barriers to implementation and potential solutions to these barriers; and study the effectiveness of a pilot intervention to improve implementation of recommendations from the inpatient geriatrics team.