Improving the Process

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University of Hawaii at Manoa John A. Burns School of Medicine Department of Geriatric Medicine Pacific Islands Geriatric Education Center Presents Improving the Process Intended Audience: physicians, administrators, pharmacists, social workers, nurses and all allied health professionals. Sponsored by Hawaii Consortium for Continuing Medical Education A joint venture between the Hawaii Medical Association and the John A. Burns School of Medicine, University of Hawai i. The Hawaii Consortium for Continuing Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Hawaii Consortium for Continuing Medical Education designates this educational activity for a maximum of 6.5 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity. Contact Information: Vicki Woolford Ph(808) 523-8461 Fax (808) 528-1897 email: woolford@hawaii.edu University of Hawaii Dept. of Geriatric Medicine, 347 N. Kuakini St. HPM-9 Honolulu, HI 96817 The HCCME fully complies with the legal requirements of the Americans with Disabilities Act rules and regulations. Persons with disabilities who may need auxiliary aids or services must request accommodations at least one month prior to the program date, so that appropriate arrangements can be made.

Improving the Process Opening Remarks: P. Blanchette, MD, MPH Transitions in Care This session will review issues related to care transitions in all settings, identify how universal processes in care delivery, medication use, and transfer forms can improve the safety and efficacy at all levels of transition. Managing Weight Loss: F325 CMS Nutrition Guidance This session will review key components of the recently updated CMS F325 surveyor guidance on nutrition. Correctable causes of anorexia and weight loss will be discussed, particularly focusing on medication as a direct and indirect cause. The evidence for medications used for appetite stimulants will also be reviewed. Improving End-of-Life Care in the Nursing Home A. Wen, MD, CMD This session will describe end-of-life needs of residents in long term care and predictors of mortality in frail nursing home residents. We will discuss what hospice and palliative care services can provide in the nursing home, and other strategies to improve end-of-life care in nursing homes. Networking, including HMDA networking meeting Pressure Ulcer Panel Discussion Moderator: A. Wen, MD, CMD Surveyor: J. Say, RN Administrative/ DON: S. Ishikawa, RN, NHA., MPH, C-DONA Wound Specialist: S. Andol Lee, RN, BSN, WCC Physician: S. Ahsan, MD QIO: D. Nelson, MS This session will provide strategies, practice advice, and resources for effective implementation of a pressure ulcer reduction program. The panel will discuss perspectives from the surveyor team, talk about the commitments necessary from the administrative team, and share practical advice from the wound specialist working in the trenches on implementation. Other resources and advice will be provided from the Quality Improvement Organization (QIO). The audience will have an opportunity to interact with the panel speakers and each other to share best practices. Quality Improvement Project: Reducing Polypharmacy in the Nursing Facility C. Bell, MD & K. Lubimir, MD This session will identify medications commonly associated with polypharmacy and adverse drug events and review the burden of polypharmacy in older adults. Results and practical lessons learned during the implementation of this quality improvement project will be highlighted. Workshop: Transitions in Care Using an actual case, the workshop will take attendees through the steps of completing a transfer summary by incorporating information about actual patients into a format that others can use for a safe transition. It will include details about how to summarize a resident/ patient s course while in the facility and how to link medical and functional information. How F329 Unnecessary Medications guidance can be used to provide the subsequent setting with key information needed for monitoring and management of treatments and medications will be discussed. Building on the morning sessions, the workshop will emphasize how this can be consistently implemented throughout Hawaii to improve care while in facilities and during and after transfers. Assistant Professor of Geriatric Medicine Assistant Professor of Geriatric Medicine Professor of Geriatric Medicine Interim Chief Operating Officer, University Clinical, Education & Research Associates Social Worker Department of Geriatric Medicine, University of Hawaii

Upon Completion of this course, participants will be able to: 1) Identify how universal processes in care delivery, medication use, and transfer forms can improve the safety and efficacy of care at all levels of transitions. 2) Identify correctable causes of anorexia and weight loss, and be able to select appropriate medications to maximize appetite. 3) Describe end-of-life needs of residents in long-term care and identify predictors of mortality in frail nursing home patients. Participants will also be able to formulate strategies to better meet end-of-life care needs in this setting. 4) Collaborate with interdisciplinary team members, integrate strategies, and draw upon resources for the effective reduction of pressure ulcers in their long-term care facilities. 5) Identify medications commonly associated with polypharmacy and adverse drug events. Participants will appreciate the components necessary to implement a polypharmacy quality improvement project. 6) Incorporate information about actual patients into a format that others can use for a safe transition to and from nursing facilities. Assistant Professor of Geriatric Medicine, Assistant Professor of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii Interim Chief Operating Officer, University Clinical, Education & Research Associates Oahu Region Chief Nurse Executive for Hawaii Health Systems Corporation at Leahi Hospital Certified wound care nurse through the National Alliance Wound Care Multi-facility director in Baltimore; writes extensively about medical direction and medical care in non-acute settings Assistant Professor of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii Director of Mountain Pacific Quality Health Foundation Hawaii office President and CEO of PharmaCare Strategies, Inc. Surveyor, State of Hawaii Department of Health, Office of Health Care Assurance Assistant Professor of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii.

REGISTRATION INSTRUCTIONS: Registration deadline is April 1, 2009. All registrations received after April 1, 2009 will be subject to a $30.00 late fee. If you are registering as a group, please submit all registration forms and payment together at the same time. Please mail your completed registration form & payment to: Pacific Islands Geriatric Education Center Attn: Vicki Woolford 347 N. Kuakini Street, HPM-9 Honolulu, HI 96817-2306 Please make checks payable to: Hawaii Medical Foundation/ Geriatrics CANCELLATION POLICY: $ 25 Cancellation Fee until April 1, 2009. Cancellation between April 1 9 will be charged a $50 service fee. No refund after April 9, 2009. Substitutions are allowed. Registration fee Group Rate (4 or more from the same facility) Additional Fees CME fee (Physician s only) Late Registration fee after April, 1,2009 $125.00 $100.00 $25.00 $30.00 The University of Hawaii John A. Burns School of Medicine Department of Geriatric Medicine Pacific Islands Geriatric Education Center reserves the right to cancel this conference or make speaker substitutions in the event of unforeseen or extenuating circumstances. The program planning committee acknowledges the support of this conference through educational grants and display fees. The HCCME, however does not imply endorsement of any commercial products. A list of exhibitors and grantors will be provided to each attendee in the conference syllabus.

Name: Address: Phone Number: Email: # of attendees @ $125.00= # of group attendees (4 or more from same facility) @ $100.00= # of attendees to acquire CME credit @ $25.00= After April 1,2009, late registration fee @ $30.00= TOTAL AMOUNT ENCLOSED= For Group Registrations Only Please list additional attendees here: Attendee #1: name/ email: Attendee #3: name/ email: Attendee #2: name/ email: Attendee #4: Name/ email: