Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.
J Am Geriatr Soc. 2022 Apr;70(4):1257-1267. doi: 10.1111/jgs.17690. Epub 2022 Feb 8.
The number of people living with dementia is growing and most patients go years without receiving a specific diagnosis or support services, leading to suboptimal care, negative impacts on the quality of life, and increased costs of care. To address these gaps, the State of Georgia Department of Human Services collaborated with academic and community partners to create the Georgia Memory Net (GMN).
GMN is a hub and spoke model partnered with Emory University's Cognitive Neurology Clinic and Emory Goizueta Alzheimer's Disease Research Center to provide training and support for best practices in diagnosis and management to Memory Assessment Clinics (MACs) throughout the state.
Communities across the State of Georgia.
GMN is a mix of academic and community providers, hospital systems, state and community agencies. Patients and families are evaluated at the MACs and connected to community services.
A dedicated clinic workflow: primary care providers (PCPs) identify a memory problem and refer to the MACs for diagnostic evaluation; meeting with a community services educator, and development of a care plan. The patient is reconnected with the PCP for continuity of care.
Initial metrics include numbers of unique patients, total patient visits, and referrals to state agency partners for community services.
GMN established five MACs across Georgia with annual state funding. Partners at Emory University provided initial training; refined patient workflows for best practices; and provide ongoing support, guidance, and continuing education for MAC teams. Local PCPs and community services partners demonstrated strong engagement with the new model.
GMN is an innovative care model to improve access to accurate and timely diagnosis in patients with memory loss. GMN may help improve the quality of life for patients and families through preventive and early care.
患痴呆症的人数不断增加,大多数患者在数年时间内都无法得到明确诊断或支持服务,导致护理效果不佳、生活质量下降,以及护理费用增加。为了解决这些问题,佐治亚州公共卫生部与学术和社区合作伙伴合作,创建了佐治亚记忆网(GMN)。
GMN 是一个枢纽辐射模型,与埃默里大学认知神经科诊所和埃默里大学戈伊苏埃塔阿尔茨海默病研究中心合作,为全州的记忆评估诊所(MAC)提供最佳诊断和管理实践的培训和支持。
佐治亚州各地的社区。
GMN 由学术和社区提供者、医院系统、州和社区机构组成。患者及其家属在 MAC 接受评估,并与社区服务机构联系。
专门的诊所工作流程:初级保健提供者(PCP)发现记忆问题并将其转介到 MAC 进行诊断评估;与社区服务教育者会面,并制定护理计划。患者与 PCP 重新建立联系,以保持连续性护理。
初始指标包括独特患者数量、总患者就诊次数,以及向州机构合作伙伴转介社区服务的次数。
GMN 在佐治亚州建立了五个 MAC,每年都有州政府拨款。埃默里大学的合作伙伴提供了初始培训;为最佳实践改进患者工作流程;并为 MAC 团队提供持续的支持、指导和继续教育。当地的 PCP 和社区服务合作伙伴对新模式表现出强烈的参与度。
GMN 是一种创新的护理模式,可以改善记忆丧失患者获得准确和及时诊断的机会。GMN 可以通过预防和早期护理来提高患者和家庭的生活质量。