"Goodbye, post acute care"

Question 1

healthcare providers know that one of the principal challenges facing our society is caring for………

Answer 1

the vast number of aging americans requiring healthcare

Question 2

in response to the rapidly aging population and an unchanging medical system, what are providers doing?

Answer 2

“re-engineering” their pathways of care to promote alternatives to repeated hospitalizations

these alternatives are:

-greater use of palliative care specialists
-greater use of geriatric nurse practicioners
-expanded roles for pharmacists and social workers and patient navigators in PATIENT AND FAMILY CENTERED, HOME BASED AND COMMUNITY PROGRAMS

Question 3

in the future, a greater portion of the heavy lifting of healthcare will be performed where?
because of this shift, the term “post acute care” is more accurately being termed……

Answer 3

in non-hospital settings

“community-based care”

Question 4

true or false

hospitals can no longer live in a 4 walls, brick and mortar world.

Answer 4

true

Question 5

________ care will be the future metric against which providers will be measured

Answer 5

COMMUNITY BASED CARE

Question 6

As mentioned, community based care will be the future metric against which providers will be measured.
what does this mean?

Answer 6

the reimbursement of providers will be based on their performance of care in MULTIPLE PROVIDER SITES by VARIOUS TYPES OF CAREGIVERS, INCLUDING IN-HOME SETTINGS

Question 7

many services are already more appropriately and affordably performed in the home.
this trend is being encouraged by what 3 things?

Answer 7

-telemedicine
-biogenetic devices
-increased electronic connectivity

Question 8

explain how increased electrical connectivity is encouraging the trend of at-home care

Answer 8

unneccesary procedures and acute care stays are reduced

also reduced — error-prone medication ordering practices and patient noncompliance

Question 9

community-based care programs are demonstrating that participation is achieved best where?

Answer 9

in the residential (home) setting with the active participation of patients and their families

-in the home, patients and family members are more relaxed and able to remember what they’re taught

Question 10

while there are exceptions, the _____ is the preferred setting to discuss disease management, prevention counseling, lifestyle changes, and end of life care

Answer 10

home

Question 11

give a new reason as to why sending providers to the home is a major benefit

Answer 11

this enables a social assessment of the environment and evaluation for referral of other services (like custodial support)

Question 12

2 new services in southern _____(state) are showing positive results using a community based approach

name the 2 programs

Answer 12

southern california

Outreach Care Network (in Pasadena)
other program is offered by CareRx (a hospice pharmacy advisory company)

Question 13

OCN started as an outpatient palliative care service but has evolved to serve patients with….

Answer 13

multiple chronic or life-limiting illnesses, most of whom have had multiple trips to ED or hospital

Question 14

give the results of OCN’s community based program and why

Answer 14

-reduced avoidable admissions and ED visits

this is bc OCN caregivers were able to give focused education and have delicate discussions regarding prognoses and end of life proceedings

Question 15

explain CareRx’s community-based program

Answer 15

sends a PHARMACIST into the home for face to face meetings with patients and family members

Question 16

explain the typical patient that is targeted in CareRx’s community-based program

Answer 16

-multiple chronic and progressive diseases
-9+ meds
-2 or more prescribing physicians
-medication adherence problems – likely to be noncompliant

Question 17

home-visiting pharmacists improve care transitions by conducting ______ at home rather than in the hospital

Answer 17

MED REC

Question 18

Explain why pharmacists were the ideal candidate in careRX’s progam

Answer 18

-they are medication experts unlike nurses and other clinicians

-patients tend to openly communicate with pharmacists, especially in the home setting

-pharmacists can actually see patient’s medications and dosage information (which patients often forget in hospital)

Question 19

pharmacists can develop ___ ___ plans

Answer 19

comprehensive medication plans

Question 20

explain the results that pharmacists achieved in CareRx’s program

Answer 20

-they’ve found and resolved duplicate medications
-found unrecognized side effects
-past or self prescribed meds that aren’t relevant to current conditions
-misunderstandings of prescriptions