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Improving Care for Older Adults with Serious Illness

Improving Care for Older Adults with Serious Illness. Amy S. Kelley, MD MSHS Brookdale Leadership in Aging, 2009 Fellow Mount Sinai School of Medicine June 8, 2011. Aims of Brookdale Fellowship.

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Improving Care for Older Adults with Serious Illness

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  1. Improving Care for Older Adults with Serious Illness Amy S. Kelley, MD MSHS Brookdale Leadership in Aging, 2009 Fellow Mount Sinai School of Medicine June 8, 2011

  2. Aims of Brookdale Fellowship • “I aim to be a leader working to promote appropriate, preference-guided medical decision making for older adults” • Research skills and mentored experience • National discussion regarding policy to improve care • Brookdale network

  3. Aim: Examine the relationship between functional status and hospital use in the last 6 months of life. • Participants: 2,493 Health and Retirement Study (HRS) decedents • Data: HRS, Medicare claims and the Dartmouth Atlas. • Outcome: Total hospital days in the last 6 months of life. • Methods: • Two-part regression models • Adjust for patient characteristics, regional resources and hospital care intensity (HCI).

  4. Characteristics Associated with Hospital Days in Last 6 Months

  5. HRS Investigators meeting • Drs. Ken Langa and Ken Covinsky • Future efforts to improve the HRS for use in aging and palliative care research.

  6. Evidence-based training in communication skills • Funded by the National Cancer Institute • Anthony Back, Robert Arnold, James Tulsky and Walter Baile • GERITALK • Intensive Communication skills training for Geriatrics and Palliative Medicine fellows • Pilot tested 2010-2011 • Added to Fellowship Core Curriculum 2011

  7. American Geriatrics SocietyJr Faculty Research SIG steering committee • Vice-Chair 2010-2011 • Mentoring Program 2011 • 90+ Mentor-Mentee matches, biggest to date! • Steering Committee Chair: 2011-2012 • Liaison to AGS Research Committee

  8. Future Directions • “I aspire to be a leader in promoting high-quality preference-guided health care to older adults with serious illness.” • Career Development Award Independent Investigator • National role in shaping policy to improve care • Clinical work in Geriatrics and Palliative Care • Translate research to clinical / educational programs • Teaching / Mentoring

  9. Thank You • Brookdale Foundation, Leadership in Aging Fellowship • Mentors : • Catherine Sarkisian, MD MSHS • Sean Morrison, MD • Susan Ettner, PhD • Neil Wenger, MD, MPH

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