Highland Hospital Physician Helps Lead Nationwide Planning to Improve Care for Older Adults Hospitalized with Hip Fractures
Monday, August 31, 2015
Older adults hospitalized with hip fractures recover more successfully when orthopaedic surgeons and geriatricians care for them in collaboration. That’s the premise of an innovative program already in place at Highland Hospital and a similar model will soon be introduced on a nationwide scale.
With support from the John A. Hartford Foundation of New York, the American Geriatrics Society (AGS) and the Association of Directors of Geriatric Academic Programs (ADGAP) will develop plans for the launch of a national program designed to replicate this collaborative co-management geriatric care model for older adults hospitalized with hip fractures. The initiative will be spearheaded under the direction of Daniel Ari Mendelson, M.S., M.D., FACP, AGSF, CMD, Associate Chief of Medicine at Highland Hospital, Professor of Medicine, Division of Geriatrics at the University of Rochester School of Medicine & Dentistry and Principal Investigator Richard W. Besdine, M.D., Professor of Medicine and Public Policy at Alpert Medical School and the School of Public Health of Brown University. William J. Hall, MD, the Paul H. Fine Professor of Medicine and Director, Center for Healthy Aging, University of Rochester co-wrote and sponsored this proposal.
With geriatrics principles at its core, the program holds promise for improving person-centered care outcomes for older people with osteoporotic fractures nationwide. Benefits also include shorter hospital stays, reduced cost, lower readmission rates, and improved mortality outcomes. Highland physicians have been experiencing success with this concept for more than 10 years. Highland’s Geriatric Fracture Center, led by Mendelson and orthopaedic surgeon, Stephen Kates, M.D. was developed in 2004 as a Center of Excellence where orthopaedic surgeons and geriatricians work together to ensure that geriatric patients with fractures have the best surgical and post-surgical care and outcomes. Highland geriatrician Susan Friedman, MD, MPH has published articles about this model in leading medical journals.
“Accomplishments of the Highland Geriatric Fracture Center are very impressive,” said Cindy Becker, Vice President and Chief Operating Officer at Highland. “The mortality and readmission rates for patients following hip fracture surgery have been substantially reduced in spite of a shorter length of stay for these patients.” These outcomes are having a positive impact on patients, families, physicians, hospitals and insurers.
Addressing risk factors for harmful events that can occur when vulnerable older adults are hospitalized reduces complications and enhances function—two goals at the heart of geriatrics care. “The Geriatric Fracture Center is an outstanding example of how interprofessional and interspecialty collaboration can improve care and quality in older adults,” said Annette Medina-Walpole, M.D., Acting Chief of Geriatrics & Aging, University of Rochester School of Medicine & Dentistry. “The national dissemination of this co-management program targeting fragility fractures is a landmark opportunity for our Division and Geriatrics as a field.”
The work conducted by AGS and ADGAP will include engaging potential sites for the co-management intervention and refining specific models and tools to integrate geriatrics and orthopedics care delivery, much like what is in place at the Highland Geriatric Fracture Center. “Highland has created an internationally known program to improve the care of older persons with hip fractures,” said Robert McCann, M.D., MACP, Highland Hospital Chief of Medicine. “This grant will help to replicate the program at other sites, improving the care of patients in other parts of the country.”
With additional support under a possible second phase of collaboration, the AGS and ADGAP ultimately will create a sustainable business enterprise to market and disseminate the co-management intervention to more than 100 leading health facilities, systems, and academic training hospitals to be tapped as “early adopters” over the next three years.
“A truly interdisciplinary, coordinated approach that involves geriatrics specialists in each step of caring for older people with osteoporotic fractures reduces complications, shortens hospital stays, decreases costs, and improves mortality,” said Mendelson.
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About the Association of Directors of Geriatric Academic Programs
Working collaboratively with the American Geriatrics Society (AGS), the Association of Directors of Geriatric Academic Programs (ADGAP) is committed to advancing academic geriatrics programs and supporting academic geriatrics program directors in order to benefit and aid patient care, research, and teaching programs in geriatric medicine within accredited medical schools located in the United States. ADGAP has built and fostered new methods of facilitating the development of leadership skills among academic geriatricians and has provided an ongoing forum for program directors and leaders in academic geriatrics to discuss the wide variety of issues that they encounter. For more information, visit adgap.americangeriatrics.org.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Its more than 6,200 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit americangeriatrics.org.
About the John A. Hartford Foundation
The John A. Hartford Foundation is a private philanthropy working to improve the health of older Americans. After three decades of championing research and education in geriatric medicine, nursing, and social work, today the Foundation pursues opportunities to put geriatrics expertise to work in all health care settings. This includes advancing practice change and innovation, supporting team-based care through interdisciplinary education of all health care providers, supporting policies and regulations that promote better care, and developing and disseminating new evidence-based models that deliver better, more cost-effective health care. The Foundation was established by John A. Hartford. Mr. Hartford and his brother, George L. Hartford, both former chief executives of the Great Atlantic & Pacific Tea Company, left the bulk of their estates to the Foundation upon their deaths in the 1950s. For more information, visit www.jhartfound.org.
About Highland Hospital
Founded in 1889, Highland Hospital has a history of innovative and personalized care. The hospital is a regional leader in specialties such as bariatric surgery, joint replacement, geriatric care, gynecologic oncology, prostate cancer treatment, women’s health services, and maternity. An affiliate of the University of Rochester Medical Center, the 261-bed organization and its 2,400 employees are committed to providing patient- and family-centered care. Go to www.Highland.urmc.edu