Project ECHO: Extension for Community Healthcare Outcomes at the BIDMC

Team ECHO-AGE
Sheila Rhea-Nobles Admin. Coordinator Angela Catic Deputy Director Melissa Mattison Deputy Director Lew Lipsitz Team Director Dan Press Team Neurologist Jason Strauss Team Geriatrics Psychiatrist

Contact Info
Sheila : 617-632-8692 Fax: 617-632-8673 snobles@bidmc.harvard.edu Projectecho@bidmc.harvard.edu

Logistics
Twice monthly ECHO-AGE Clinics
Wednesdays, 11:30 am-1:30 pm

First ECHO-AGE Clinic = June 13

Case Discussions

15 min Educational Pearl

Template Med List Clock Draw

Order of Cases Emailed

2d
14d 7d 1d

Select Case

Fax Template, Med List, Clock Draw

 Initial ECHO-AGE Clinic

Delirium and Dementia in short-term rehab and long-term care

Future ECHO-AGE Clinics:

Pain management Falls/Syncope Diabetes Bone health

Template Med List Clock Draw

Order of Cases Emailed

2d
14d 7d 1d

Select Case

Fax Template, Med List, Clock Draw

Template
ECHO ID # will be assigned at the time of first presentation. Please include for follow-up case presentations. Bradykinesia - slowness of movement Rigidity Dr. Press to explain Geriatric Depression Score

Clock Drawing
1. Ask patient to draw a clock like they would see on the wall 2. Place all the numbers on the face of the clock 3. Set the time for 10 minutes past eleven 4. If patient cannot draw a circle, you may provide this, but please indicate this on the form

Continence
Refers to urinary incontinence New fecal incontinence is important to note as well

Digit Span Tests

Forward: 815 259 4961 5391 38672 76238 426738 931687 3548962 1587239 71682435 86591427 538712469 317954826 Backward: 51 69 582 174 7295 9735 56891 71948 153296 417839 3716948 9134872 48563129 52843761

Normal Digit Span Forward ~7. Normal Digit Span Backward should not differ from Forward by more then 2 digits

Overall ECHO-AGE Evaluation

1. 2. 3. 4. Operational Educational Patient Focused System based
Ongoing assessment to better meet your needs

Operational
Satisfaction
PLEASE complete your survey from todays meeting and turn into Sheila before you leave

Logistics

Educational
Improved confidence caring for elders with delirium and dementia Knowledge gains regarding delirium and dementia diagnosis and management

*Patient Focused*
Data collection - vital to success and expansion to other clinical topics Identify lead contact from your site to work with Sheila on data collection Data
Antipsychotic use Admissions to acute care hospitals Mortality Social Engagement Functional status (score calculated from MDS)

System Based Metrics

Cost ($) Preventable transfers of care Quality metrics
Compliance with antipsychotic administration and physical restraint guidelines