GERIATRIC PRACTICE IMPROVEMENT Innovations in Practice Module 3 Ed Vandenberg, MD, CMD Geriatric Section OVAMC & Section of Geriatrics 981320 UNMC Omaha, NE 68198-1320 evandenb@unmc.edu Web: geriatrics.unmc.edu Welcome to the Geriatric Practice Improvement Module 3 on Innovations in Practice. I am Ed Vandenberg with the University of Nebraska Medical Center Section of Geriatrics, the VA Medical Center in Omaha and faculty of the Nebraska Geriatric Education Center. If you have not finished module one and two of Geriatric Practice improvement, please close out of this module, complete module one and two and then return to this module.

OBJECTIVES Upon completion the learner will be able to: List the key elements of a successful practice caring for the elderly Describe successful, innovative, nontraditional geriatric practice types List the pro’s, con’s, and caveats of contracting your services Describe the process of performing an analysis of a practice site. This is a very interesting module. We hope that upon completion the learner will be able to: list the key elements of a successful practice caring for the elderly, describe some successful, innovative, and nontraditional geriatric practice types. List the pro’s, con’s, and caveats of contracting your services. And lastly, describe the process of performing an analysis of a practice site.

MOTIVATION Caring for Elders rewarding Financial rewards variable Success requires adaptation to environment This slide is to explain the motivation for this module. Elders have proven to be the most rewarding groups of patients to care for. A survey of many disciplines in 2002 demonstrated that those with predominant geriatric practices had the highest satisfaction ratings over any other specialty including general family medicine. But due to the time it takes to deliver care to this population and the capricious and parsimonious payment by Medicare, one cannot always garner the amount of income one deserves for the effort. This module will describe a variety of innovative practices that have prospered and satisfied the provider. Then it will assist you in an analysis of your situation and help your to decide where you would like to take your practice. Arch Intern Med 2002. 162: 1577-1584

Thanks to the American Geriatric Society ( AGS) Utilize American Geriatric Society ( AGS) Tool Kit Web site Brought to you by the generosity of the American Geriatric Society Be sure to visit web site http://www.americangeriatrics.org/ No voice, all text These modules are brought to us by the generosity of the American Geriatric Society ( AGS) Tool Kit Web site I encourage you to be sure to visit their web site http://www.americangeriatrics.org/. These modules have no voice, they are all text, so you finally have the opportunity to stop listening to me..

EXPLANATION OF PROCESS Close out and return to Geriatric Practice Main page Complete all 4 short modules in sequence Complete the questions at end of module Complete the evaluation of the module How this works is that after you finish this slide, close out this portion and return to Geriatric Practice Main page. Then complete all 4 short modules in sequence, that is “Chapters” 1 through 4 by clicking on each file opening and read or download.. Chapter one is a single page and is an introduction. Chapter two is on various practice types. Chapter three is on contracting services and the last Chapter 4, covers a system to analyze a practice site or your practice. On all 4 of these chapters you only need to scroll down and complete the whole page. Then to receive credit, you must both complete the questions at end of the module and then complete the evaluation of the modules. I wish you well with this module and hope you find it as interesting and helpful as I have. 1) Ger Prac General Principles 2) Ger Prac Practice Modules 3) Ger Prac Contracting servicesa 4) Ger Prac Practice Analysis

Post-test A contract with a nursing facility to provide medical direction and care for a small portion of the residents should include all but one of the following Clearly outline the specific terms of the arrangement Duties to be performed, Incentives for more admission by you to the facility Fees for services Liability insurance coverage Notice of contract termination.

Answer; 3) Incentives for more admissions by you to the facility A contract should be negotiated and signed with each organization for which you provide contract services. The contract should clearly outline the specific terms of the arrangement and include duties to be performed, fees for services, insurance coverage, and notice of contract termination. However financial incentives to admit more patients would be both a legal and ethical violation. end