Multifaceted programs to prevent the use of potentially inappropriate medications, efforts to reduce certain unnecessary medical procedures, and novel interventions for linking particularly vulnerable older adults to Medicare are among headline presentations anchoring the American Geriatrics Society (AGS) Annual Scientific Meeting (AGS16), held May 19-21 at the Long Beach Convention & Entertainment Center in Long Beach, Calif.
Presentations at the prestigious Plenary Paper Session at AGS16 (May 19, 10-11 a.m.) represent some of geriatrics most promising scholarship as assessed by peer experts and program planners from a pool of more than 800 abstract submissions. This year’s highlights include:
- EQUiPPED Expansion: Results from a multi-site quality improvement initiative to change prescribing practices in VA Medical Center Emergency Departments (EDs): As the U.S. moves closer to reimbursing quality rather than quantity of care, improvement initiatives will be front-and-center across our health system. EQUiPPED is one such initiative–an ongoing, multi-component program involving a range of health professionals at several Veterans Affairs EDs. By focusing on decreased use of potentially inappropriate medications, EQUiPPED has led to a significant and sustained reduction in inappropriate prescribing, suggesting that it could find a home throughout the VA–America’s largest integrated health network.
- Clinical outcomes related to a quality improvement intervention to reduce unnecessary urinary catheter utilization in hospitalized older adults: Unnecessary use of urinary catheters can expose frail older adults to serious complications, from urinary tract infections to falls, pressure ulcers, and increased mortality. Researchers exploring a multi-part educational intervention involving posters, small group teaching sessions, and changes to physician order and clinical documentation systems found that these program plans resulted in significant changes in catheter use at a large academic hospital. Strategies incorporating several approaches to prevention and awareness could continue to reduce catheter use and the challenges it presents for older adults–an important model for potential future growth across other areas of expertise.
- The Willie Sutton effect in health care: Independence at Home qualifying (IAH-Q) criteria identify high need, high cost Medicare beneficiaries: Medicare’s Independence at Home (IAH) Demonstration is among the more promising demonstrations in a portfolio of novel payment and service delivery models to promote better care, better health, and lower costs through health system improvements. A key component of the IAH design is the focus on the frailest, highest cost Medicare beneficiaries, who received home based primary care from mobile teams led by physicians and nurse practitioners. Assessing 2011-2012 Medicare data, researchers determined that IAH qualifying criteria were indeed effective for identifying individuals who bear a disproportionate share of deaths, hospitalizations, readmissions, and long-term care among those eligible for Medicare.
With the population of Americans 65-years-old and older expected to crest 70 million by 2030, providing high-quality, cost-effective health care now and in the future will be imperative. AGS16 stands at the crossroads between a growing demand for expert health professionals and the need for innovation supporting the health, safety, and independence of older adults across the U.S. and around the world.