Janet C. Frank

Preparing Patients and Caregivers to Participate in Care Delivered Across Settings: The Care Transitions Intervention

Objectives: To test whether an intervention designed to encourage older patients and their caregivers to assert a more active role during care transitions can reduce rehospitalization rates.

A Randomized Clinical Trial of Outpatient Comprehensive Geriatric Assessment Coupled with an Intervention to Increase Adherence to Recommendations

BACKGROUND: Although comprehensive geriatric assessment (CGA) has been demonstrated to confer health benefits in some settings, its value in outpatient or office settings is uncertain.

The Care Transitions Intervention: A Patient-Centered Approach to Ensuring Effective Transfers Between Sites of Geriatric Care

ABSTRACT During an episode of illness, older patients may receive care in multiple settings; often resulting in fragmented care and poorly-executed care transitions. The negative consequences of fragmented care include duplication of services; inappropriate or conflicting care recommendations, medication errors, patient/caregiver distress, and higher costs of care. Despite the critical need to reduce fragmented care in this population, few interventions have been developed to assist older patients and their family members in making smooth transitions. This article introduces a patient-centered interdisciplinary team intervention designed to improve transitions across sites of geriatric care.

Cost-effectiveness of outpatient geriatric assessment with an intervention to increase adherence.

BACKGROUND Comprehensive geriatric assessment (CGA) can be effective in inpatient units, but such inpatient settings are prohibitively expensive. If similar benefits could be obtained in outpatient settings, CGA might be a more attractive option. OBJECTIVES To assess the cost-effectiveness (CE) of an outpatient geriatric assessment with an intervention to increase adherence. SUBJECTS Three hundred fifty-one community-dwelling, elderly subjects with at least one of four geriatric conditions. MEASURES In addition to the measures of functioning, we collected data on the costs of the intervention itself and on the use of medical services in the 64 weeks after the intervention. RESULTS The intervention, which prevented functional decline, cost

Disciplinary split: A threat to geriatrics interdisciplinary team training

273 per participant. The intervention group averaged three more visits than the control group in the first 32 weeks after the intervention, but only 1.2 extra visits in the next 32 weeks. We estimate that the costs of these additional medical services would be

Assessing Care of Vulnerable Elders—Alzheimer's Disease: A Pilot Study of a Practice Redesign Intervention to Improve the Quality of Dementia Care

473 for the 5 years after the intervention, leading to a total cost per Quality Adjusted Life Year (QALY) of

Managing Geriatric Syndromes: What Geriatric Assessment Teams Recommend, What Primary Care Physicians Implement, What Patients Adhere To

10,600. CONCLUSIONS The CE of this program compares favorably with many common medical interventions. Whether investments should be made in health care resources on treatments that lead to modest improvements in the functioning of community-dwelling elderly people remains a societal decision.

Addressing Fidelity in Evidence-Based Health Promotion Programs for Older Adults

In 1995, the John A. Hartford Foundation launched an initiative to strengthen geriatric interdisciplinary team training (GITT) for advanced practice nursing and masters‐level social work students and residents in internal medicine and family practice. As part of the national evaluation of the initiative, case‐study and cross‐case designs were employed using quantitative and qualitative data to examine the influence of cultures, regulations, and attitudes of individual disciplines on interdisciplinary training efforts at the first eight GITT programs.

Closing the dementia care gap: Can referral to Alzheimer's Association chapters help?

OBJECTIVES: To determine whether a practice redesign intervention coupled with referral to local Alzheimers Association chapters can improve the quality of dementia care.

Building Academic Geriatric Capacity: An Evaluation of the John A. Hartford Foundation Centers of Excellence Initiative

OBJECTIVES: To evaluate the responses of primary care physicians and patients to recommendations from a commmunity‐based comprehensive geriatric assessment (CGA) program for management of four target conditions: falls, depression, urinary incontinence, and functional impairment.