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Biomedical subjects

Eugenia L Siegler

Publications and source records attributed to Eugenia L Siegler.

5 recordsLinked to original sources
PubMed2006

Improving the transition to home healthcare by rethinking the purpose and structure of the CMS 485: first steps.

Transition points are the weak links in communication between providers. As an example, the discharge home often is a hurried "handoff" from inpatient physician to home care agency, whose visiting nurse admits the patient for a period of observation, medication management, rehabilitation, and teaching. The primary means of communication between physician and home health agency is the CMS 485, a form that contains the orders and that physicians frequently sign well after patients begin receiving services. This paper describes the first phase of a project that restructured and automated the CMS 485 using an existing electronic health record. The principles guiding the restructuring are described along with early reaction to and revision of the form to address operational issues. The paper also discusses evaluation plans and a web-based system of communication that will be developed in the second phase of the project.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2005

Creating a teaching geriatric service: ten important lessons.

The restructuring of The Medical Service at the Weill/Cornell campus of the New York Presbyterian Hospital, coupled with funding from the Donald W. Reynolds Foundation to strengthen physicians' training in geriatrics, enabled the creation of a geriatrics inpatient team and a 17-bed Acute Care for Elders unit. It has also allowed a program to be designed that exposes residents to the fundamental principles of geriatric care, offers them opportunities to follow older patients in multiple venues, and provides a chance to enhance their skills and gain experience in interdisciplinary care. In creating the service, a number of mistakes were made, but a few lessons were also learned in the process. After a brief description of the program, 10 lessons that highlight the pitfalls and potential of an inpatient geriatrics teaching service are shared.

Aged↗
PubMed2004

Treatment of urinary incontinence with anticholinergics in patients taking cholinesterase inhibitors for dementia.

Clinicians often encounter patients with dementia and urge incontinence who might benefit from both an anticholinergic medication and a cholinesterase inhibitor. At first glance, this combination would seem to violate basic principles of geriatric pharmacology, as the drugs appear to be working at cross-purposes and anticholinergic medications are notorious for worsening cognitive function in susceptible patients. A case is presented and discussed in which this combination was clinically effective and pharmacologically sound.

Aged↗
PubMedDate not supplied

Optimal staffing for Acute Care of the Elderly (ACE) units.

Acute Care of the Elderly (ACE) units have been shown to improve outcomes for hospitalized elders. Because the literature offers little to describe the appropriate staffing of such units, we surveyed ACE units about their size, configuration, staffing, patient selection, training, and outcomes data. Although we had anticipated speaking with staff from 30 to 40 units, we were able to poll key personnel on only 18 ACE units. This article describes staffing and continuous quality improvement data for these sites.

Activities of Daily Living↗