Michael L. Malone, MD Aurora Health Care November 10, 2017 Want to Champion Better Care for Vulnerable Older Americans? Start Here: Michael L. Malone, MD Aurora Health Care November 10, 2017

A Champion in Sports:

A Champion in Health Care: Advocates for patients. They personify excellent care. They are with patients. They stay on the job with resilience. They are experts in their content matter. They understand systems of care. They work in service to their community. What is it that makes for a champion? Ellen Danto-Nocton,MD

To Champion: To take on a responsibility for a cause. To advocate for or clear the field for the triumph of an idea. A verb.

What are some steps I could take to champion better care for my patients?

1) Strive to better understand the needs of those who are particularly vulnerable: Describe the clinical challenge which your patient faces. Listen carefully to define what is unique about the problem. Define which systems of care are not going well… and why? Understand the context of the care. Ask: “Why is the care this way?”. Review geriatrics best practice models- in response to vulnerable older patients.

2) Measure the care being provided and describe the public health implications of the problem: Describe a case that is important. Describe a series of cases, and the themes that are consistent through them. Compare your care to the literature. Describe the implications for your organization. Describe the implications for your state & nation.

3) Focus your efforts on strategies to improve the coordination of care: Elicit the patient preferences and goals. Focus on becoming good listeners to our patients and their family caregivers. Communicate well: as team members. with those who work beyond the hospital. Use evidence- based, best practice models for transitions from one site to the next.

There is a severe shortage of geriatrics experts. 4) Implement, sustain, and disseminate best-practice models that do not require geriatricians: There is a severe shortage of geriatrics experts. America needs systems of practice which will increase the number of health professionals who practice geriatrics principles. Acute Care for Elders. Hospital Elder Life Program. Geriatrics Emergency Departments. Stepping On- Falls Prevention Program. Chronic Disease Self- Management Programs.

5) Work with colleagues who are not like you: Work with team members who have diverse training, perspectives, and talents: Nursing. Social service experts and those from community organizations. Pharmacists. Dieticians. Rehab experts. Chaplains. Electronic health records experts. Hospital administration Librarians. Volunteers.

6) Engage in policy issues that have implications for the people you care for: Read about and understand the health policy issues which affect your patients. Find trusted resources. Engage with the public policy committee of your professional organization. Communicate with your elected representatives. Advocate for better care. Use your clinical expertise to inform good policy.

What is the answer to improving care for older adults in America?

What is the answer to improving care for older adults in America?

References: The Commonwealth Fund International Experts Working Group on Patients with Complex Needs. Designing a High-Performing Health Care System for Patients with Complex Needs—Ten Recommendations for Policymakers. The Commonwealth Fund and the London School of Economics and Political Science, 2017. Malone ML, Want to Champion Better Care for Vulnerable Older Americans? Start Here, J Am Geriatr Soc 2017, accepted for publication. Martin RL, Osberg SR. Getting Beyond Better: How Social Entrepreneurship Works. Boston: Harvard Business Review Press, 2015.