journal club 2/getting old is not for the weak

Question 1

T/F? Reducing variability improves outcomes?

Answer 1

True

Question 2

Current Rehabilitation Hierarchy for
Older Adults Following Hospitalization primarily focuses on what first and what last?

Answer 2

First (mostly): General conditioning
last (least): resistance training

Question 3

Updated Rehabilitation Hierarchy forOlder Adults Following Hospitalization focuses on what mostly and what less?

Answer 3

Most: Hight intensity resistance training
least: general conditioning.

Question 4

The median time patients spend walking in the hospital is ?

Answer 4

7 min a day

Question 5

T/ F. Rates of hospital associated deconditioning have not changed significantly over time despite changes in the standards of care in hospitals

Answer 5

True

Question 6

T or F, median number of steps/day are greater than 1000 for SNF patients.

Answer 6

False, around 800

Question 7

What is known to be the biggest predictor of AE (adverse events) such as falls, hospitalization after SNF?

Answer 7

functional status

Question 8

What is the FIM and what does it look at?

Answer 8

Functional independence measure, indicates how much assistance is required for the individual to carry out activities of daily living.

Question 9

Are patients generally more active throughout day post D/C to home from SNF?

Answer 9

No, they remain relatively just as inactive

Question 10

Why are “never events” such as fall risk safety precautions bad for patient?

Answer 10

scares staff and contributes to less mobilization to reduce risk and costly fees/lawsuits for hospitals

Question 11

What are the barriers for optimal practice patterns?

Answer 11

1) reemburment based vs evidence based practice
2) limited incentives for high quality transitional care
3) fear of adverse events (fear of litigation)
4) current emphasis on returning patient to PLOF low
5) lack of awareness of effective clinical care strategies

Question 12

Changes that have helped prioritized High-Quality Transitional Care?

Answer 12

1) The Improving Medicare Post-Acute Care Transformation (IMPACT) Act
2) Accountable Care Organizations
3) Bundled Care

Question 13

Is high intensity perceived as unsafe in hospitals?

Answer 13

Yes

Question 14

Instead of having someone do a LAQ for resistance training how may we generate more force to mimic daily functional tasks instead?

Answer 14

Sit to stands

Question 15

What is PACE?

Answer 15

Program of all inclusive care for the elderly

Question 16

How long is the PACE program and what functional outcomes does it use?

Answer 16

6 week rehab program, uses gait speed and SPPB (short physical performance battery)

Question 17

Telerehabilitation consists of ?

Answer 17

1) Biobehavioral coaching
2) Individual PT sessions
3) Group PT sessions

Question 18

High-Intensity Feasible and Effective in the SNF? T or zf

Answer 18

T

Question 19

3 components of the “HERO” behavioral economics?

Answer 19

1) establish baseline
2) goal selection
3) gamification