TY - JOUR
KW - Accidental Falls
KW - Aged, 80 and over
KW - Chronic Disease
KW - Dementia/nursing/psychology
KW - Depression/nursing/psychology
KW - Female
KW - Geriatric Nursing
KW - Heart Failure/nursing/psychology
KW - Hospitals, Teaching/organization & administration
KW - Humans
KW - Male
KW - Nurse Practitioners
KW - Patient Care Team/organization & administration
KW - Program Evaluation
KW - Quality of Health Care
KW - Statistics as Topic
KW - Urinary Incontinence/nursing/psychology
AU - D. A. Ganz
AU - B. K. Koretz
AU - J. K. Bail
AU - H. E. McCreath
AU - N. S. Wenger
AU - C. P. Roth
AU - D. B. Reuben
A1 - 
AB - OBJECTIVE: To determine whether nurse practitioner (NP) comanagement can improve the quality of care for 5 chronic conditions in an academic geriatrics practice. STUDY DESIGN and METHODS: From September 2006 to September 2007, 18 primary care geriatricians were divided into an intervention group that could refer patients to an NP for comanagement of dementia, depression, falls, heart failure, and/or urinary incontinence, or a control group that indicated which patients would have been referred to the NP for these conditions. The NP used structured visit notes to guide care delivery for the 5 conditions concordant with Assessing Care of Vulnerable Elders-3 (ACOVE-3) quality indicators. We reviewed charts to determine adherence to recommended processes of care. RESULTS: A total of 200 patients (108 intervention, 92 control) were eligible for at least 1 process of care recommended by ACOVE-3 for the 5 conditions. Patients' mean (SD) age was 85 years (7 years), 67% were women, and patients were eligible for a mean (SD) of 6.9 (4.4) processes of care. Intervention patients were eligible for more care processes than controls (7.8 vs 5.9 processes per patient; P = .002). Quality of care was higher for patients in the intervention group compared with the control group (54% vs 34% of care processes completed; P <.001). The adjusted absolute difference between intervention and control groups in care processes completed was 20% (95% confidence interval = 13%, 27%). CONCLUSION: NP comanagement of 5 chronic conditions was associated with higher quality of care, even in a practice of geriatricians.
BT - The American Journal of Managed Care
C5 - General Literature
CP - 12
CY - United States
IS - 12
JF - The American Journal of Managed Care
N2 - OBJECTIVE: To determine whether nurse practitioner (NP) comanagement can improve the quality of care for 5 chronic conditions in an academic geriatrics practice. STUDY DESIGN and METHODS: From September 2006 to September 2007, 18 primary care geriatricians were divided into an intervention group that could refer patients to an NP for comanagement of dementia, depression, falls, heart failure, and/or urinary incontinence, or a control group that indicated which patients would have been referred to the NP for these conditions. The NP used structured visit notes to guide care delivery for the 5 conditions concordant with Assessing Care of Vulnerable Elders-3 (ACOVE-3) quality indicators. We reviewed charts to determine adherence to recommended processes of care. RESULTS: A total of 200 patients (108 intervention, 92 control) were eligible for at least 1 process of care recommended by ACOVE-3 for the 5 conditions. Patients' mean (SD) age was 85 years (7 years), 67% were women, and patients were eligible for a mean (SD) of 6.9 (4.4) processes of care. Intervention patients were eligible for more care processes than controls (7.8 vs 5.9 processes per patient; P = .002). Quality of care was higher for patients in the intervention group compared with the control group (54% vs 34% of care processes completed; P <.001). The adjusted absolute difference between intervention and control groups in care processes completed was 20% (95% confidence interval = 13%, 27%). CONCLUSION: NP comanagement of 5 chronic conditions was associated with higher quality of care, even in a practice of geriatricians.
PP - United States
PY - 2010
SN - 1936-2692; 1088-0224
EP - 55
EP - e343+
T1 - Nurse practitioner comanagement for patients in an academic geriatric practice
T2 - The American Journal of Managed Care
TI - Nurse practitioner comanagement for patients in an academic geriatric practice
U1 - General Literature
U2 - 21291291
VL - 16
VO - 1936-2692; 1088-0224
Y1 - 2010
ER -