Accreditation The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: The American Medical Directors Association designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AMDCP Credit Designation: This session has been approved for a total of clinical 1.0 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: The PACE Model Practices have been developed to respond to PACE clinicians’ concerns of being measured against interventions in accepted Clinical Practice Guidelines (CPGs) that were not developed for older adults with multiple comorbidities and varying goals of care. This session will review the development of a patient centered approach that first defines the patient’s goal of care and uses that to suggest which interventions of a standard CPG are appropriate or not appropriate for that person. Presenters will then provide key recommendations of the PACE Model Practices developed for patients with Heart Failure. Suggested quality measurements will be discussed in this same context of individualized patient decision making. Access to the PACE Model Practices including CHF, diabetes, chronic kidney disease, chronic obstructive pulmonary disease, and preventive care will be granted to the audience.
Identify benefits and limitations of using CPGs in the geriatric population.
Describe the process for developing the NPA Model Practices and how they might be used to manage CHF.
Use quality measures in an individualized approach in an older population with functional impairments.
Speaker(s): Laura Trice, MD, CMD; Verna Sellers, MD, MPH, CMD
Reference(s): National Quality Forum. Measuring performance. www.qualityforum.org. Accessed December 8, 2010 Boyd CM, Darer J, Boult C, et al. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: Implications for pay for performance. JAMA 2005; 294: 716-724 Tinetti ME, Bogardus ST, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med 2004; 351: 2870-2874 Schamp R, Tenkuu L. Managed death in a PACE: Pathways in present and advance directives. J Am Med Dir Assn 2006; 7:339-344 Shekelle P, Vijan S. Quality Indicators for the Care of Diabetes Mellitus in Vulnerable Elders. J Am Geriatr Soc 2007; 55: S312-S317 Fried TR, Tinetti ME, Iannone L. Primary care clinicians ' experiences with treatment decision making for older persons with multiple conditions. Arch Intern Med. 2011;171(1): 75-80 American Geriatrics Society Expert Panel of the Care of Older Adults with Multimorbidity. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians. http://www.americangeriatrics.org/annual_meeting/2012_meeting_handouts/amhandouts050512/guiding_principles050512 accessed July 4, 2012 Designing Health Care for the Most Common Chronic Condition-Multimorbidity. Tinetti, ME, Fried TR, Boyd CM. JAMA, June 20, 2012 Vol 307, no 23 page 2493-2494