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，是一名经过董事会认证、接受过研究员培训的实习生。作为印第安纳大学(IU)医学系普通内科和老年病学部的助理教授，以及雷根斯特里夫健康护理研究所(RIHC)和印第安纳大学老龄研究中心(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，并研究过信息系统在医疗保健中的影响。韦纳博士35个月的教职生涯取得了成功，这得益于他的才华和培训，以及他丰富的环境。伊利诺伊州立大学医学院教职员工为一大批老年患者提供护理 最先进的临床实验室。克莱门特·J·麦克唐纳医学博士在现场开发了世界上最大和最全面的医疗记录系统之一。克里斯托弗·M·卡拉汉医学博士是IUCAR的创始主任，其主要研究主题是初级保健和社区环境中老年人的健康促进和慢性病管理。史蒂文·R·康塞尔医学博士是路易斯安那州立大学老年病学主任。韦纳博士寻求从事一项研究事业，专注于改善老年人的协调能力和护理质量。这项提议的目的是帮助韦纳博士弥合他早期的内部支持和最终作为一名独立教员提供的外部资金之间的差距。卡拉汉博士将担任主要导师，麦克唐纳博士和康塞尔博士将担任次要导师。韦纳博士还将在临床老年病学、医疗质量、行为改变和临床试验方面进行正式培训。 老年病学顾问为住院的老年患者提供团队方法和许多服务的协调，但由于初级保健医生未能采纳大多数建议，顾问的有效性受到限制。在拟议的研究中，我们力求衡量和改进实施顾问建议的各个方面。这项建议的具体目的是对住院老年病咨询进行前瞻性研究，以确定执行的具体决定因素；向医生和患者的重点小组介绍结果和主题，以就执行障碍和这些障碍的潜在解决方案达成共识；以及研究试点干预措施的有效性，以改善住院老年病团队建议的执行情况。

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.