Huot Charisse, Cruz-Knight Wanda, Jester Dylan J, Wenders Anna, Andel Ross, Hyer Kathryn
BayCare Health System, University of South Florida-Morton Plant Mease Family Medicine Residency, Clearwater, Florida, USA.
Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida, USA.
Gerontol Geriatr Educ. 2022 Apr-Jun;43(2):285-294. doi: 10.1080/02701960.2020.1854247. Epub 2020 Dec 3.
We established a Geriatrics Workforce Enhancement Program (GWEP) clinic to enhance resident training on comprehensive preventive care and chronic disease management, and to increase the number of older patients who received Medicare Annual Wellness Visit (AWV) preventive services. A total of 1,104 patients were tracked at baseline and during the intervention period. Patients were grouped into two categories: Adult (aged 55-64) and Senior (aged 65+). Clinical quality measures were monitored by electronic health record and tracked through monthly reports at baseline (May 2018) and during the intervention period (July 2018-June 2019). In the Senior group, the proportion of patients receiving the Medicare AWV increased after GWEP began ( <.001). Additionally, the Senior group showed significant improvements in the frequency of body mass index assessments ( = .04), colorectal cancer screenings ( < .001), advance directive documentation ( < .001), cognitive screenings ( < .001), and pneumococcal vaccinations ( < .001). In the Adult group, a trending increase was seen in influenza vaccinations ( = .06). Curricular innovations including the establishment of a GWEP clinic in our residency outpatient center, development of new educational materials, and use of a nurse coordinator resulted in significant improvements in the percentage of older adults who received the Medicare AWV benefit and preventive health performance metrics.
我们设立了一个老年医学劳动力强化项目(GWEP)诊所,以加强住院医师在综合预防保健和慢性病管理方面的培训,并增加接受医疗保险年度健康检查(AWV)预防服务的老年患者数量。在基线期和干预期共跟踪了1104名患者。患者分为两类:成年人(55 - 64岁)和老年人(65岁及以上)。临床质量指标通过电子健康记录进行监测,并在基线期(2018年5月)和干预期(2018年7月 - 2019年6月)通过月度报告进行跟踪。在老年组中,GWEP开始后接受医疗保险AWV的患者比例有所增加(<.001)。此外,老年组在体重指数评估频率( =.04)、结肠直肠癌筛查(<.001)、预先医疗指示记录(<.001)、认知筛查(<.001)和肺炎球菌疫苗接种(<.001)方面有显著改善。在成年组中,流感疫苗接种有上升趋势( =.06)。课程创新包括在我们的住院医师门诊中心设立GWEP诊所、开发新的教育材料以及使用护士协调员,这使得接受医疗保险AWV福利的老年人比例和预防健康绩效指标有了显著改善。