health care of the elderly - cfpc.ca · 1. cfpc & other associations dunikowski family medicine...

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Health Care of the Elderly FAMILY MEDICINE FORUM Nov 3 - 5, 2011

Health Care of the Elderly: Agenda

Dunikowski FAMILY MEDICINE FORUM 2011

Visit and practice with Health Care of the Elderly (HCOE) information in these areas:

1. CFPC & other associations & organizations

2. Guidelines

3. Keeping up to date

4. Clinical practice tools

5. Patient & health information

Questions/Answers Wrap-up

1. CFPC & other associations


CFPC Health Care of the Elderly Program –in CFPC Section of Family Physicians with Special Interests or Focused Practices (SIFP) | Section des médecins de famille avec intérêts particuliers ou pratiques ciblées (IPPC)

The Health Care of the Elderly Program Committee is the executive body for the program On committee web pages: What’s new, Who we are,

Resources

To get to committee pages, use search box or Directories pulldown > Committees or >Sections

http://www.cfpc.ca/Elderly_Program_Committee/

Information on CFPC Website

3 tabs- What’s New, Who We Are,

Resources


Breadcrumb trail

Pull down DIRECTORIES > Committees or > Sections

Examples

"Priorities for the Health Care of the Elderly" The Role of the Family Physician CFPC;2007. [PDF]

Evidence-Based Care of the Elderly Health-Guide CFPC;2002. [PDF]

These are listed on HCOE Program Committee page on Resources tab

Reports & Resources


http://www.cfpc.ca/local/files/Programs/Patient Care/Care_Elderly/HCOE_Discussion_Paper_June_07.pdf

http://www.cfpc.ca/local/files/Programs/Patient Care/Triscott.pdf

HCOE Associations/Organizations


Find various types of information on these websites - Clinical Tools, Discussion, Guidelines, Patient Information, News & Events

American Geriatrics Society Canadian Association on Gerontology Canadian Coalition for Seniors’ Mental Health Canadian Geriatrics Society Centre de recherche de l'Institut universitaire de gériatrie de Montréal Long Term Care Medical Directors of Canada National Initiative for the Care of the Elderly Ontario Long Term Care Physicians Société québécoise de gériatrie Regional Geriatric Programs of Ontario La Société française de gériatrie et gérontologie

http://www.cagacg.ca/

http://www.americangeriatrics.org/

http://www.cagacg.ca/

http://www.ccsmh.ca/en/default.cfm

http://www.canadiangeriatrics.com/

http://www.iugm.qc.ca/












http://www.cmda.info/

http://www.nicenet.ca/

http://oltcp.ca/

http://www.sqgeriatrie.org/







http://rgps.on.ca/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

http://www.sfgg.fr/

Information on CFPC Website - Training


Program Directors: Directories pulldown > University Programs > online Directory of Departments, select Care of Elderly Program Directors from the pulldown menu or click here

Standards for Accreditation PDF (Appendix A for HCOE standards) | Critères pour l’agrément des programmes de résidence PDF (Annexe A)

Continuing professional development CPD upcoming events

http://www.cfpc.ca/English/cfpc/education/section of residents/resource/sor3-rdyear/default.asp?s=1

http://www2.cfpc.ca/local/asp/cfpc/FMDirectoryDetail.asp

http://www.cfpc.ca/uploadedFiles/Red Book English.pdf

http://www.cfpc.ca/uploadedFiles/Red Book French.pdf

http://www.cfpc.ca/UpcomingEvents/


Information on CFPC Website - Training

Care of the Elderly Residency Program

Directors



• Also see resources at CFPC Library Care of the Elderly Subject Guide http://www.cfpc.ca/CareOfTheElderly/

• To get to library pages: Resources pulldown > Library Services or use search box

Information on CFPC Website - Library

http://www.cfpc.ca/CareOfTheElderly/

Search for HCOE resources


Search box

P L E A S E T A K E A F E W M I N U T E S T O E X P L O R E H E A L T H C A R E O F T H E E L D E R L Y R E S O U R C E S

O N T H E C F P C W E B S I T E .

Q U E S T I O N S ?


Information on CFPC Website

2. Guidelines: what do you do?


Favorite website?

Google?

Guidelines databases?

Other databases e.g. TRIP?

Books – digital or print?

Guideline articles in journals?

Integrated with your EMR?

Ask a colleague?

Other?

2. Guidelines


Advantages & disadvantages of different methods?

Google may work well, but it can be difficult to determine whether you have the most recent information, since results are not sorted by date

National guidelines databases may be comprehensive, but may not be very user-friendly

Not enough Canadian content can be a problem

Guidelines

National Guidelines Databases (all topics) CMA – CPG Infobase

US National Guidelines Clearinghouse

UK - NICE Guidance NHS http://www.nice.org.uk/

The above are all listed on CFPC Library Guidelines page

HCOE Guidelines American Geriatrics Society Guidelines

British Geriatrics Society Guidelines

Regional Geriatric Program, Hamilton ON Resources

Towards Optimized Practice (Alberta) – Clinical Practice Guidelines (Note: scroll to foot of individual guideline summaries for full download, or click on CPG download from left hand menu)


http://www.cma.ca/index.php/ci_id/54316/la_id/1.htm

http://www.cma.ca/index.php/ci_id/54316/la_id/1.htm

http://www.guideline.gov/

http://www.nice.org.uk/

http://www.cfpc.ca/ClinicalPracticeGuidelines/

http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/

http://www.bgs.org.uk/index.php?option=com_content&view=category&id=42&Itemid=455

http://www.rgpc.ca/resource/index.cfm

http://www.topalbertadoctors.org/cpgs.php

TOP – Clinical Practice Guidelines


http://www.topalbertadoctors.org/informed_practice/clinical_practice_guidelines.html

Guidelines – Examples

Antiphospholipid Syndrome , Thrombosis Interest Group of Canada Heart Failure diagnosis and management, Canadian Cardiovascular

Society, 2006 [PDF] 2009 update [PDF] Dementia. Diagnosis and treatment of dementia: 6. Management

of severe Alzheimer disease CMAJ article also free in PubMed Central, PubMed record (5 other articles in this series)

Diabetes Mellitus Clinical Practice Guidelines (Canadian Diabetes Association)

Hypertension CHEP /Hypertension Canada Recommendations 2011 update

Mental Health: Assessment and Treatment of Delirium Guideline (Canadian Coalition for Seniors’ Mental Health)


http://www.tigc.org/clinicalguides/Antiphospholipids.aspx



http://www.ccs.ca/download/consensus_conference/consensus_conference_archives/Arnold_CCS_final.pdf

http://www.ccs.ca/download/consensus_conference/consensus_conference_archives/HF_up_2009.pdf

http://www.cmaj.ca/content/179/12/1279

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585109/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585109/

http://www.ncbi.nlm.nih.gov/pubmed/19047609

http://www.diabetes.ca/for-professionals/resources/2008-cpg/

http://www.hypertension.ca/chep-recommendations

http://www.ccsmh.ca/en/natlGuidelines/delirium.cfm

TRIP database http://www.tripdatabase.com/


Evidence based

Fast & free

Developed by UK general practitioners

Filter retrieval by resource type

Guidelines is a resource type – others: synopses, systematic reviews, etextbooks, clinical Q&A, patient information, news

http://www.tripdatabase.com/

Trip Database: Clinical Search Engine



P L E A S E T A K E A C O U P L E O F M I N U T E S T O P R A C T I C E W I T H T R I P O R E X P L O R E O T H E R

G U I D E L I N E S S I T E S


Guidelines

3. How do you keep up to date?


Email alerts

RSS feeds

Podcasts

CPD events and courses

Others?

EvidenceUpdates

Regular email alerts of best evidence from the literature

Published by BMJ Group

Free but need to register

Tailor to discipline – e.g. geriatrics, or other options

Tailor for relevance and newsworthiness ratings

Also a searchable database of all alerts

http://plus.mcmaster.ca/EvidenceUpdates/




Or a Population


Select a Discipline

EvidenceUpdates in your Mailbox



RSS feeds


• RSS = Really Simple Syndication

• Way to disseminate regularly updated content such as news and announcements

• Feeds contain a list of summaries along with a link to the full version of the Web content

• Feed readers automatically check for updates and download new files to your computer

• Feed readers incorporated in browsers eg Internet Explorer or web-based such Google Reader

RSS feeds in Internet Explorer


RSS icon will be orange if

it detects a feed

Another example of website with feed


RSS icon will be orange if

it detects a feed


…This dialogue box appears

Clicking on RSS icon takes you to feed page

See your feeds by clicking on Favorites


Go to Favorites when you want to see what’s new


List of feeds in Google Reader


For more information “Getting started with Google Reader”

http://www.google.com/support/reader/bin/answer.py?answer=113517

http://www.google.com/support/reader/bin/answer.py?answer=113517

Podcasts

Use RSS technology

Feed readers e.g. iTunes automatically check for updates and download new files to your computer

Audio files in MP3 format

Listen on computer, iPod, other MP3 player

Most are free

Learn about iTunes podcasts here

OR use other free software e.g. Juice

Help at most sites that have podcasts, e.g. CDC here


http://www.macworld.com/article/54680/2010/09/organize_podcasts.html

http://juicereceiver.sourceforge.net/

http://www2c.cdc.gov/podcasts/podcasthelp.asp

Podcasts - Examples


Therapeutics Education Collaboration (Canadian)

Journal contents & highlights from many journals e.g. JAMA

CDC http://www2a.cdc.gov/podcasts/ see “Healthy aging” series under Browse

Johns Hopkins podcasts

InfoPOEMS podcast (Essential Evidence Plus)

http://therapeuticseducation.org/podcast

http://jama.ama-assn.org/misc/audiocommentary.dtl

http://www2a.cdc.gov/podcasts/

http://www.hopkinsmedicine.org/mediaII/Podcasts/

http://www.essentialevidenceplus.com/subscribe/netcast.cfm



Subscribe to podcasts in iTunes


Go to iTunes Store in the left column of the jukebox window

Select “Podcasts” from the menu bar along the top of the store …. There’s also a link to Podcasts at the foot of the screen

If you click the little arrow to the right of Podcasts on the top menu bar, you can select a category, e.g. Science & Medicine

Subscribe by clicking on “Subscribe” icon, or copying and pasting the address of the podcast you want into your feed reader


iTunes Store

iTunes store link

Science & Medicine podcast page


Click here to Subscribe


You can also search iTunes & filter by Podcasts


CPD – where to find lists?


CFPC website > CPD > Upcoming Events

Online CME – Geriatrics

Medscape Geriatrics Learning Center and News


Portal of Online Geriatric Education POGOe Free public repository of geriatric educational materials in various e-learning formats, including lectures, exercises, virtual patients, case-based discussions, simulations, as well as links to other resources.

Need to register, but some content is freely accessible e.g. http://www.pogoe.org/cme

http://www.cfpc.ca/CPD/


http://www.cmelist.com/geriatrics.htm




http://www.medscape.com/

http://www.pogoe.org/



http://www.pogoe.org/cme

Upcoming CPD Events on CFPC website


Portal of Online Geriatric Education POGOe




P L E A S E T A K E A C O U P L E O F M I N U T E S T O E X P L O R E S O M E O F T H E S E R E S O U R C E S

Q U E S T I O N S ?


Keeping up to date

4. Clinical Practice Tools


Where to find?

Association and organization pages

Dedicated web pages

Collections of resources e.g. Regional Geriatrics Program

Apps on iTunes

Others?

Many clinical practice tools are listed in the Resources section of the Health Care of the Elderly Program Committee

http://www.cfpc.ca/Elderly_Program_Committee/

Regional Geriatric Programs of Ontario rgps.on.ca


Geriatrics, Interprofessional Practice and Interorganizational Collaboration Toolkit

Collection of many tools


http://rgps.on.ca/

http://rgps.on.ca/giic-toolkit









Other examples of Clinical Practice Tools


Cognitive Impairment Flow Sheet (BC Ministry of Health PDF)

Dementia Predictor Calculators (Sunnybrook Health Sciences Centre)

Depression Assessment & Treatment Tool (NICE)

Driving and Dementia Toolkit (RGP Eastern Ontario)

http://www.cfpc.ca/local/files/Programs/Care_of_the_elderly/BCMoH - cognitive_appendix_g1.pdf

http://sunnybrook.ca/research/?page=AlzheimerPrediction_ca_Home

http://www.nicenet.ca/files/Folding_NICE_depression_tool_combined.pdf

http://www.champlaindementianetwork.org/uploads/Resources/kitjune09.pdf

Geriatric Depression Scale

at Stanford http://www.stanford.edu/~yesavage/GDS.html

Various other locations e.g. BC Guidelines in PDF

Geriatric Patients Annual Follow-up (PDF)

Montreal Cognitive Assessment Tool (MOCA)

Trail Making Tests, Parts A & B (University of Iowa)

Life expectancy calculator (MediResource Inc.)


Other examples of Clinical Practice Tools

http://www.stanford.edu/~yesavage/GDS.html

http://www.bcguidelines.ca/pdf/cognitive_appendix_b.pdf

http://stage.cfpc.ca/uploadedFiles/Directories/_PDFs/Geriatric Patient Annual Follow-up Sheet.pdf

http://www.mocatest.org/

http://www.healthcare.uiowa.edu/igec/tools/cognitive/trailMaking.pdf

http://bodyandhealth.canada.com/health_tools.asp?t=10&text_id=2974&channel_id=10&relation_id=10864


Geriatrics At Your Fingertips – App on iTunes


Geriatrics At Your Fingertips

P L E A S E T A K E A F E W M I N U T E S T O E X P L O R E T H E S E R E S O U R C E S

D O Y O U H A V E O T H E R S U G G E S T I O N S ?


Clinical practice tools

5. Patient & health information for seniors


Public Health Agency of Canada, Seniors’ Health

MedlinePlus – Seniors area

NIH Senior Health

Medical Library association – top senior health websites

CDC Healthy Aging http://www.cdc.gov/aging/

http://www.phac-aspc.gc.ca/sh-sa-eng.php

http://www.nlm.nih.gov/medlineplus/

http://nihseniorhealth.gov/

http://caphis.mlanet.org/consumer/seniorhealth.html





http://www.cdc.gov/aging/

Public Health Agency of Canada Aging & Seniors


http://www.phac-aspc.gc.ca/seniors-aines/index-eng.php

MedlinePlus

SENIORS


http://www.nlm.nih.gov/medlineplus/

National Institutes of Health Senior Health


http://nihseniorhealth.gov/

Medical Library Association – Senior Health Websites you can Trust

Senior Health




D O Y O U H A V E O T H E R S U G G E S T I O N S ?


Patient information

Health Care of the Elderly: Summary


We looked at 5 different types of HCOE information and where to find them:

1. CFPC & other associations & organizations

2. Guidelines

3. Keeping up to date

4. Clinical practice tools

5. Patient & health information

Questions?

T H A N K S !

D R . F R E D M A T H E R , H C O E P R O G R A M C O M M I T T E E

L Y N N D U N I K O W S K I

D I R E C T O R O F L I B R A R Y S E R V I C E S , C F P C

Q U E S T I O N S T O : c l f m @ u w o . c a


health care of the elderly - cfpc.ca · 1. cfpc & other associations dunikowski family medicine...

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