Recommendations of Inpatient Geriatrics Consultation

描述（由申请人提供）：迈克尔韦纳，医学博士，公共卫生硕士是一个委员会认证，奖学金培训的内科医生。 作为印第安纳州大学（IU）医学系普通内科和老年医学系的助理教授，以及Regenstrief医疗保健研究所（RIHC）和IU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着广泛的背景，他使用过大型数据库，并研究了信息系统对医疗保健的影响。 韦纳的35个月的教师已经成功，因为他的才华和培训，以及他丰富的环境。 医学院的IU学院照顾老年患者的大量人口， 最先进的临床实验室 医学博士Clement J McDonald开发了世界上最大和最全面的医疗记录系统之一。 Christopher M.医学博士卡拉汉是IUCAR的创始主任，其主要研究主题是在初级保健和社区环境中促进老年人的健康和管理慢性病。 Steven R. Counsell，MD是IU的老年医学主任。 韦纳寻求追求的研究生涯，重点是提高老年人的护理协调和质量。 这个提议的目的是帮助韦纳博士弥合他作为一名独立的教师研究员的早期校内支持和最终校外资助之间的差距。 卡拉汉博士将是主要的导师，麦克唐纳博士和康塞尔博士将是次要的导师。 韦纳博士还将接受临床老年病学、医疗保健质量、行为改变和临床试验方面的正式培训。 老年医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。 在建议的研究中，我们会衡量和改善顾问建议的实施情况。该提案的具体目标是对住院老年病咨询进行前瞻性研究，以确定实施的具体决定因素;向医生和患者的重点群体介绍调查结果和主题，就实施障碍和解决这些障碍的潜在解决方案达成共识;并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实施。

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.