By Tom Demko
Pennsylvania is the 6th most populous state in the nation with over 12 million residents, and an economy that ranks 6th in the United States in terms of Gross Domestic Product (GDP). While broad statistics like this make our state look comparatively strong and competitive, Pennsylvania has a unique demographic profile that challenges healthcare delivery.
According to the World Bank, both the world population in general, and US population specifically, are trending toward an urban bias – with 17% of the US population living in rural communities in 2012, down from 20% in 2002. However, Pennsylvania has a rural population of 3.5 million – or about 27% of its population, a 2% increase in the same 10 year period. In contrast to demographic trends that number is projected to climb through 2030 by another 3%. Pennsylvania has the largest rural population in the country.
Alzheimer’s disease (AD) is a progressive, neurodegenerative disorder that is the leading cause of dementia in the elderly (60%), affecting 13-20% of people over the age of 65 years.
In AD, the synaptic connections between neurons degenerate, and when neurons lose their connections, they cannot function properly and eventually die. As neuronal death spreads through the brain, the brain itself starts shrinking in a process called brain atrophy.
Unfortunately, only a few medications have been approved to help control cognitive loss in AD, however, they do not stop or reverse the underlying disease process. In fact, most new AD candidate drugs are failures. Only one agent has been approved since 2004 (memantine), and the failure rate since 2002 (excluding agents currently in Phase 3) is 99.6% (1). One major problem is that we do not know the cause of AD. Recent evidence suggests that neurons die as a result of toxic metabolites that are unable to be removed properly from the brain along the blood vessels.
New technology is urgently needed to identify large numbers of biomolecules in brain cells and related biofluids such as serum and CSF. At Protea, we call this “Molecular Information” – identifying the proteins, metabolites, and lipids, which are produced by cells, so that we can profile the molecular networks that define AD biological processes.
ACMH, one of only 26 hospitals in the state, has been recognized by The Hospital and Healthsystem Association of Pennsylvania (HAP) for exceptional performance and participation as part of its Pennsylvania Hospital Engagement Network (PA-HEN).
HAP’s PA-HEN created the “Safety Across the Board” Excellence Award to recognize participating hospitals’ achievement of exceptional performance and participation in the PA-HEN and with the Partnership for Patients (PfP) program goals of reducing preventable harm and readmissions. To qualify for the award, a hospital must meet both performance and participation criteria for acute care hospitals.
“Pennsylvania hospitals are to be commended for the accomplishments achieved to date,” said HAP President and CEO Andy Carter. “The PA-HEN’s teamwork, effective leadership practices, accountability, and patient-centered care principles have assisted Pennsylvania hospitals with moving closer toward the vision of a healthy Pennsylvania through improved patient safety and quality of care.”
ACMH’s exceptional safety performance was noted in the following adverse event areas: Catheter-Associated Urinary Tract Infections (CAUTI), Central Line-Associated Blood Stream Infections (CLABSI), Surgical Site Infections (SSI), Pressure Ulcer Prevention (PUP), Readmissions (REA), Venous Thromboembolism (VTE), and Ventilator-Associated Events (VAE).
“Our thanks go out for the conscientious effort by all staff which has gone into making this facility a safer place for patients,” said John Lewis, President and CEO of ACMH. “A benchmark milestone among our hospital peers.”
For additional information regarding HAP PA-HEN’s patient safety efforts, visit haponline.org.
As a senior care professional you’ve likely seen firsthand the frustration that can arise when a family lacks clear communication surrounding a loved one’s choices as they age. A new program called the 40-70 Rule® : An Action Plan for Successful AgingSM offers free tips, conversation starters, and other resources that can help seniors discuss difficult aging topics with their families.
One of the best ways to make sure everyone is on the same page is for seniors and their families to have essential conversations surrounding aging issues such as driving, dating, finances, lifestyle and end of life care wishes. You are in a unique position to encourage your patients and their loved ones to discuss these important topics.
Home Instead, Inc., franchisor of the Home Instead Senior Care® franchise network, has developed a public education program called the 40-70 Rule®: An Action Plan for Successful AgingSM, to encourage families to intentionally discuss aging-related issues when the children are approaching age 40 and the parents are approaching age 70. At the heart of this program is the Action Plan for Successful Aging. This is a free tool you can download and provide to your patients and their families to help guide their conversations and planning.
CAREGivers from Home Instead Senior Care can make a difference in the lives of older adults and their families by providing support with companionship, meal planning and preparation, transportation and outings, and activities of daily living to help keep them independent for as long as possible. For more information about Home Instead Senior Care visit www.homeinstead.com/greaterpittsburgh or call 1-866-996-1087
This Pennsylvania State Board of Examiners of Nursing Home Administrators approved specialty program is designed to provide a knowledge core of education for those interested in pursuing a career in the long term care administration field. The courses may also serve to satisfy State of Pennsylvania license renewal requirements. Consisting of sixteen courses, each 7.5 hours in length, the 120-hour program is taught by Penn State University faculty and area professionals.
*Penn State School of Nursing is an approved provider of continuing nursing education by the PA State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Dates: September 25, 2014 to November 14, 2014
Day/Time: Thursdays and Fridays 8:30 a.m. to 5:00 p.m.
Location: Penn State Greater Allegheny
Courses may be taken individually for $140 each
Southwestern PA Partnership for Aging (SWPPA) is holding their Annual Meeting, “Addressing Today’s Challenges for Aging Consumers,” on Wednesday December, 3rd from 8am to 4pm at Robert Morris University in Moon Twp.
New This Year at SWPPA!
- Round Robin Table Discussions & Networking: Sponsorship opportunities available!
- The agenda includes:
- Findings on Family Caregiver Needs and Issues Presented by the AARP and United Way
- Behavioral Health Issues in Older Adults Presented by the PA Behavioral Health and Aging Coalition
- Health Literacy Presented by the Regional Health Literacy Coalition
- The Future of Long Term Care and Aging – Panel Presentation by Experts from State Organizations
- Policy Direction of Long Term Care and Aging in Pennsylvania – Panel Presentation by State Legislators
The program will provide 5 CEU hours for Social Workers, Nurses, Nursing Home Administrators and Personal Care Home Administrators.
Questions may be directed to Lucy Cichon at 412-595-7554 firstname.lastname@example.org
or Betty Karleski at 412-352-0703 or email@example.com
Physicians need to be especially careful when managing chronic pain with opioid medications. Medical practices often seek risk management advice when they suspect a patient is misusing prescription medications, is not complying with treatment, or when the patient is making unreasonable demands for more opioids. If a patient suffers harm as a result of opioid medication use, a physician may find himself the target of a lawsuit alleging negligent treatment of chronic pain.
How Does the Management of Opioids Create Potential Liability?
- Claims against physicians for negligent treatment and/or management of opioid medications frequently arise from the following:
- Prescribing opioids without performing any diagnostic examinations
- Prescribing an excessive quantity of opioids
- Prescribing additional narcotics when not indicated
- Failing to consider, screen for, or suspect narcotic addiction, and failing to refer the patient for treatment of drug addiction
- Negligent monitoring
- Failing to consult or refer to a pain specialist
Is the Story Clear?
The physician might think that he or she has managed a patient’s pain appropriately, but if the medical record documentation does not reflect that, defense of care is difficult. Examples of poor documentation include:
- No indication that the treating physician reviewed the patient’s prior medical records or studies
- No physical exam results
- No quantitative assessments of the patient’s pain
- No indication that the treating physician discussed the risk of opioid addiction
- No pain medication agreement
- No evidence of assessment of effectiveness of the pain medications
- No rationale for the physician’s medication choices
- No copies of narcotic prescriptions
Today’s guest post is by Mike Figliuolo, the author of One Piece of Paper: The Simple Approach to Powerful, Personal Leadership. Here’s Mike:
As leaders, we’re always going to go through difficult times. When we were more junior we had other people to pick us up when we fell down. As a kid it was a parent or a coach who would dust us off and say “Get back out there.” We’ve had bosses who have been helpful when we faced crises.
But now, the higher you are in terms of leadership roles in your organization and the more people you’re leading, the fewer people there are to pick you up and dust you off. You need to be in a position where you can lead yourself out of those difficult situations.
Your team is watching you to see how you behave when you face adversity. Having a leadership maxim to help you motivate yourself and lead yourself through that difficult situation to get to the other side can be a very powerful tool to have.
Our health care environment poses a number of barriers to effective communication, including shorter hospital stays, more technologically complex medical care, and constrained resources. As college students return to school this month, a new STTI book will be a great resource for nursing educators and students to hone their communication skills before entering the health care field.
Cheri Clancy, MSN, MS, RN, NE-BC, has witnessed these barriers firsthand during her 15 years of nursing leadership and patient experience. In her new book, Critical Conversations in Healthcare: Scripts & Techniques for Effective Interprofessional & Patient Communication, Clancy takes a how-to approach on incorporating body language, emotional competence, and script tips into one user-friendly and practical manual.
I recall numerous forecasts of things to come, be it weather via Joe or the Farmers’ Almanac or the future of healthcare. Somehow, something that we did not forecast occurs and VOILA! … a different future emerges.
I remember the early 1980s when the forecasters said we had way too many hospital beds in Allegheny County. Advancements in medical technology, it was predicted, would drive down the need for hospital stays.
In Pennsylvania, and elsewhere, the bed issue was addressed via Certificate of Need (CON) requirements. This was intended to control the growth of beds and reduce overlapping or unnecessary services. The CON era did not go exactly as planned. Many of my clients were in fact posturing to add beds. They feared that if they actually closed beds they would never get them back (from the state) when they needed them. What was the real reason we needed to eliminate beds? I’ve forgotten at this point.
Time passed, The CON law sunset and we added beds.
Discussing aging issues, such as living arrangements, finances, dating, end-of-life decisions and driving, early and often can save families years of heartache, tension and even legal battles. Yet, research indicates that about two-thirds of American families put off these conversations, either because they are uncomfortable with the topics or they just don’t know where to start. 1
Statistics show that 34 percent of adults surveyed are conversation avoiders. 2 That is, they haven’t talked about any important end-of-life issues with their parents or children, or they have talked about just one issue.
To help, the local Home Instead Senior Care office is sponsoring the “40-70 Rule®” program, which includes an Action Plan for Successful AgingSM and other resources to help ease these conversations between adult children and their parents.