For Older, Vulnerable Adults, Team-Based Health Care Improves Quality of Care for Three Common Conditions
Friday, October 30, 2015
There’s room for improvement in the quality of care for older adults in the U.S., say the authors of a new study published in the Journal of the American Geriatrics Society. And when physicians delegate care to other trained professionals like nurse practitioners, physician assistants, and registered nurses, older patients can benefit in meaningful ways.
The researchers examined data from the Assessing Care of Vulnerable Elders (ACOVE) project, a group of studies that developed “quality indicators” (QIs) that evaluate the quality of care for older adults who have difficulty coping with their health challenges. One of the ACOVE projects, the ACOVE-2 model, for example, aimed to improve outpatient care processes by emphasizing team care, which involves working with other medically-licensed members of a physician’s health care staff to take patient histories, counsel patients about specific problems, and refer patients to community-based groups.
In this new study, researchers pooled results from nine ACOVE projects that included over 16,000 QIs from nearly 5,000 patients. They examined three conditions common to vulnerable older adults, and whether team-based care affected their outcomes:
- Falls and fear of falling
- Cognitive impairment/dementia
- Urinary incontinence
The researchers concluded that, when it comes to managing these three conditions, delegating specific aspects of health care to nurse practitioners, physician assistants or registered nurses can mean higher quality care for older, vulnerable adults. “When health care staff work to the highest level of their professional training, patients receive higher quality care,” says Dr. Lichtenstein, one of the researchers.
This is particularly good news for geriatrics, since this field of medicine is already known for its team-based approach to caring for older people and supporting their families and caregivers. A typical geriatrics care team may include a geriatrician, nurse, physician assistant, social worker, pharmacist, nutritionist, physical therapist, occupational therapist, speech and hearing specialist, or psychiatrist. These geriatrics healthcare professionals have special skills in evaluating older people’s medical, social, and emotional needs. For this reason, they’re well prepared to spot and address common eldercare concerns such as incontinence, falls, memory problems, and the need to manage multiple chronic conditions and medications.
This summary is from “The Effect of Physician Delegation to Other Health Care Providers on the Quality of Care for Geriatric Conditions.” It appears online ahead of print in the Journal of the American Geriatrics Association. The study authors are Brian J. Lichtenstein, MD; David B. Reuben, MD; Arun S. Karlamangla, MD, PhD; Weijuan Han, MSPH; Carol P. Roth, RN, MPH; Neil S. Wenger, MD, MPH.