@article{
 title = {Combining Quality Improvement and Geriatrics Training: The Nursing Home Polypharmacy Outcomes Project},
 type = {article},
 year = {2014},
 identifiers = {[object Object]},
 keywords = {Geriatric Education,Geriatric Medicine Fellowship,Nursing homes,Polypharmacy,Quality improvement},
 month = {5},
 day = {14},
 city = {a The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine , University of Hawaii , Honolulu , Hawaii , USA.},
 id = {8286ebd4-9d1b-3cac-ab35-efcd6af22e2c},
 created = {2016-08-21T22:19:01.000Z},
 file_attached = {false},
 profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},
 group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},
 last_modified = {2017-03-14T09:54:45.334Z},
 read = {false},
 starred = {false},
 authored = {false},
 confirmed = {true},
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 source_type = {JOUR},
 notes = {ID: 69639; JID: 8101294; OTO: NOTNLM; aheadofprint},
 folder_uuids = {63a49397-62a3-4051-829d-7112ba34c71e},
 private_publication = {false},
 abstract = {ABSTRACT To examine sustained effects of an educational intervention, we repeated a successful quality improvement (QI) project on medication safety and cost-effectiveness. In October 2007 and August 2008, facility leadership and geriatrics faculty identified all patients receiving >/=9 medications (polypharmacy cohort) in a 170-bed teaching nursing home and taught Geriatric Medicine fellows (n=12 in 2007, 11 in 2008) to: 1) systematically collect medication data; 2) generate medication recommendations (stop, taper, or continue) based on expert criteria (Beers Criteria) or drug-drug interaction programs; 3) discuss recommendations with patients' attending physicians; and 4) implement approved recommendations. Over the two projects, the polypharmacy cohorts demonstrated decreased potentially inappropriate medications (odds ratio (OR) 0.78, 95% confidence interval (95%CI)0.69-0.88, p<0.001), contraindicated medications (OR=0.63, 95%CI=0.47-0.85, p=0.002) and medication costs (OR=0.97, 95%CI=0.96-0.99, p<0.001). Our findings suggest that programs planning educational QI projects for trainees may benefit from a multi-year approach to maximize both clinical and educational benefits.},
 bibtype = {article},
 author = {Kojima, G and Bell, C L and Tamura, B and Davis, J and Inaba, M and Lorenzo, P and Blanchette, P L and Iwasaki, W and Masaki, K},
 journal = {Gerontology & geriatrics education}
}

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