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Article ; Online: Tailoring the electronic health record to reduce inappropriate prescribing.

Mozer, Christine L / Madden, William / Cursio, John F / Kostas, Tia

Journal of the American Geriatrics Society

2022 Volume 70, Issue 11, Page(s) 3311–3315

MeSH term(s)	Humans ; Inappropriate Prescribing/prevention & control ; Electronic Health Records ; Drug Prescriptions ; Practice Patterns, Physicians'
Language	English
Publishing date	2022-07-18
Publishing country	United States
Document type	Letter ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.17963
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Article ; Online: Rates of Inappropriate Dosing in Older Adults at an Urban, Academic Hospital.

Mozer, Christine / Madden, William / Cursio, John / Kostas, Tia

American journal of medical quality : the official journal of the American College of Medical Quality

2021 Volume 36, Issue 6, Page(s) 469–470

MeSH term(s)	Aged ; Hospitals, Urban ; Humans ; Inappropriate Prescribing
Language	English
Publishing date	2021-04-01
Publishing country	Netherlands
Document type	Letter ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1131772-3
ISSN	1555-824X ; 1062-8606
ISSN (online)	1555-824X
ISSN	1062-8606
DOI	10.1097/01.JMQ.0000751156.52061.64
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Article ; Online: Interprofessional Education Without Limits: A Video-Based Workshop.

Szafran, Jennifer C Houpy / Thompson, Katherine / Pincavage, Amber T / Saathoff, Mark / Kostas, Tia

MedEdPORTAL : the journal of teaching and learning resources

2021 Volume 17, Page(s) 11125

Abstract: Introduction: Interprofessional collaboration improves patient outcomes. Many institutions lack access to learners from other health care professions, limiting the feasibility of many published interprofessional curricula. We created a video-based ... ...

Abstract	Introduction: Interprofessional collaboration improves patient outcomes. Many institutions lack access to learners from other health care professions, limiting the feasibility of many published interprofessional curricula. We created a video-based workshop to fill the need for an introductory interactive interprofessional activity for third-year medical students (MS 3) in their internal medicine clerkship, in which other health care students and standardized patients were not readily accessible. Methods: This session introduced medical students to the interprofessional model of care through a video workshop. Learners engaged in reflective observation as a video presented a physician interviewing a patient. The training and roles of interprofessional providers were discussed with the aid of video demonstrations. Learners completed postworkshop and postmedicine clerkship surveys with responses indicated using a Likert scale (1 = Results: Sixty-seven MS 3s participated in this workshop; postworkshop survey response rate was 82%. Of students who responded to the surveys, 87% agreed that the video increased their understanding of when it would be beneficial to consult interprofessional team members. Students' confidence in interacting with interprofessional team members improved from a mean of 3.0 before the workshop to 3.7 after the workshop. At the end of the medicine clerkship, 71% indicated that the video improved their ability to work with interprofessional team members at least moderately. Discussion: This video-based workshop improved students' self-rated understanding of interprofessional team members' roles and increased their confidence interacting with other members of the interprofessional health care team.
MeSH term(s)	Aged ; Curriculum ; Humans ; Interprofessional Education ; Interprofessional Relations ; Patient Care Team ; Students, Medical
Language	English
Publishing date	2021-03-24
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ISSN	2374-8265
ISSN (online)	2374-8265
DOI	10.15766/mep_2374-8265.11125
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Article ; Online: Medication management in older adults and interprofessional education: A needs assessment.

Kostas, Tia / Knoebel, Randall / Levine, Stacie

Gerontology & geriatrics education

2018 Volume 41, Issue 1, Page(s) 100–108

Abstract: Elderly, multi-morbid patients are at high risk for suffering adverse drug events. Safe medication management is a key process in preventing these adverse events, and requires interprofessional teamwork. We performed a needs assessment survey of ... ...

Abstract	Elderly, multi-morbid patients are at high risk for suffering adverse drug events. Safe medication management is a key process in preventing these adverse events, and requires interprofessional teamwork. We performed a needs assessment survey of graduating medical students and faculty to evaluate student training in medication management, in particular students' preparedness in the three minimum geriatrics competencies pertaining to medication management, interprofessional educational opportunities, and optimal learning methods. Response rates were 45/105 (43%) for students and 38/93 (41%) for faculty. The majority of students felt that they did not receive sufficient training in medication management in older adults. Faculty either agreed with students or were unsure whether students received sufficient training. Neither students nor faculty felt that students were extremely prepared to carry out the three minimum geriatrics competencies at the time of medical school graduation. Students and faculty identified direct patient care experiences as the optimal learning method, and inappropriate medications as the highest priority topic. Students and faculty felt that students do not receive sufficient interprofessional educational opportunities. The results of this study are currently being used to create customized interprofessional educational experiences for medical students related to medication management in older adults.
MeSH term(s)	Adult ; Aged ; Attitude of Health Personnel ; Education, Medical, Undergraduate/methods ; Faculty, Medical/psychology ; Female ; Geriatrics/education ; Humans ; Interprofessional Relations ; Male ; Medication Therapy Management/education ; Middle Aged ; Needs Assessment ; Students, Medical/psychology ; Surveys and Questionnaires
Language	English
Publishing date	2018-06-21
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	605726-3
ISSN	1545-3847 ; 0270-1960
ISSN (online)	1545-3847
ISSN	0270-1960
DOI	10.1080/02701960.2018.1487297
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Article ; Online: Improving medical and pharmacy student confidence in medication management and attitudes about interprofessional collaboration by utilizing an interprofessional module.

Kostas, Tia / Thomas, Jiz / Thompson, Katherine / Poston, Jason / Levine, Stacie

Journal of interprofessional care

2018 Volume 32, Issue 6, Page(s) 790–793

Abstract: Adverse drug events are common and often preventable. Educating the interprofessional workforce to appropriately manage medications as part of a team is a priority. An interprofessional medication management module for graduating medical and pharmacy ... ...

Abstract	Adverse drug events are common and often preventable. Educating the interprofessional workforce to appropriately manage medications as part of a team is a priority. An interprofessional medication management module for graduating medical and pharmacy students was developed. The module was case-based and co-led by physicians and pharmacists. Students completed pre- and post-module surveys regarding their attitudes about interprofessional collaboration, confidence in managing medications, and self-reported ability to perform the tasks laid out in the minimum geriatrics competencies as a result of the module. Eighteen medical and 13 pharmacy students participated over a two-year period. There was statistically significant improvement in students' attitudes about interprofessional collaboration with regards to understanding their role and the role of others on the interprofessional team, and about teamwork between medical and pharmacy students. There was also statistically significant improvement in confidence with regards to the 3 medication management competencies after completion of the module. The vast majority of students agreed that the module improved their self-reported ability to manage medications. An interprofessional medication management module is an effective way to improve medical and pharmacy students' attitudes about interprofessional collaboration and confidence in medication management.
Language	English
Publishing date	2018-08-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1099758-1
ISSN	1469-9567 ; 0884-3988 ; 1356-1820
ISSN (online)	1469-9567
ISSN	0884-3988 ; 1356-1820
DOI	10.1080/13561820.2018.1512957
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Article ; Online: Community resource referral needs among African American dementia caregivers in an urban community: a qualitative study.

Abramsohn, Emily M / Jerome, Jessica / Paradise, Kelsey / Kostas, Tia / Spacht, Wesley Alexandra / Lindau, Stacy Tessler

BMC geriatrics

2019 Volume 19, Issue 1, Page(s) 311

Abstract: Background: African American caregivers of community-residing persons with dementia are mostly unpaid and have high rates of unmet basic and health needs. The National Alzheimer's Project Act (NAPA) mandates improved coordination of care for persons ... ...

Abstract	Background: African American caregivers of community-residing persons with dementia are mostly unpaid and have high rates of unmet basic and health needs. The National Alzheimer's Project Act (NAPA) mandates improved coordination of care for persons with dementia and calls for special attention to racial populations at higher risk for Alzheimer's Disease or related dementias (ADRD) to decrease health disparities. The purpose of this study is to describe the perceptions of African American caregivers of people with dementia about community resources needed to support caregiving as well as their own self-care. Methods: Using a qualitative study design, in-depth, semi-structured qualitative interviews were conducted with caregivers (N = 13) at an urban geriatric clinic to elicit community resource needs, barriers to and facilitators of resource use and how to optimize clinical referrals to community resources. Caregivers were shown a community resource referral list ("HealtheRx") developed for people with dementia and were queried to elicit relevance, gaps and insights to inform delivery of this information in the healthcare setting. Data were iteratively coded and analyzed using directed content analysis. Results represent key themes. Results: Most caregivers were women (n = 10, 77%) and offspring (n = 8, 62%) of the person with dementia. Community resource needs of these caregivers included social, entertainment, personal self-care and hospice services. Main barriers to resource use were the inability to leave the person with dementia unsupervised and the care recipient's disinterest in participating in their own self-care. Facilitators of resource use included shared caregiving responsibility and learning about resources from trusted sources. To optimize clinical referrals to resources, caregivers wanted specific eligibility criteria and an indicator of dementia care capability. Conclusions: African American caregivers in this study identified ways in which community resource referrals by clinicians can be improved to meet their caregiving and self-care needs.
MeSH term(s)	Adult ; African Americans/psychology ; Aged ; Aged, 80 and over ; Caregivers/psychology ; Caregivers/standards ; Dementia/psychology ; Dementia/therapy ; Female ; Health Resources/standards ; Humans ; Male ; Middle Aged ; Qualitative Research ; Referral and Consultation/standards ; Self Care ; Urban Population
Language	English
Publishing date	2019-11-14
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-019-1341-6
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Article ; Online: ECHO-Chicago Geriatrics: using telementoring to "geriatricize" the primary care workforce.

Jafari, Pari / Kostas, Tia / Levine, Stacie / Martinchek, Michelle / Johnson, Daniel / Graupner, Jeffrey / Thompson, Katherine

Gerontology & geriatrics education

2019 Volume 41, Issue 3, Page(s) 333–341

Abstract: Background: The primary care workforce is under-prepared to care for the growing older adult population. Extension for Community Healthcare Outcomes (ECHO) is a continuing education intervention that connects subspecialists and community health care ... ...

Abstract	Background: The primary care workforce is under-prepared to care for the growing older adult population. Extension for Community Healthcare Outcomes (ECHO) is a continuing education intervention that connects subspecialists and community health care providers (HCPs) via videoconferencing technology for didactic and case-discussion sessions.
Language	English
Publishing date	2019-02-01
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	605726-3
ISSN	1545-3847 ; 0270-1960
ISSN (online)	1545-3847
ISSN	0270-1960
DOI	10.1080/02701960.2019.1572005
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Article ; Online: A Qualitative Study of Preclinical Medical Students Randomized to Patient-Partnered vs Traditional Clinical Experiences.

Tang, Joyce W / Kostas, Tia / Verma, Anshu / Press, Valerie G / Kushner, Josef / Gier, Nicole / Wiklund, Lauren O / Arora, Vineet M / Farnan, Jeanne / Meltzer, David O

Journal of patient-centered research and reviews

2022 Volume 9, Issue 4, Page(s) 290–297

Abstract: Purpose: Longitudinal patient-partnered experiences may promote medical student empathy, but evaluation of such programs is limited. The aim of this study was to compare areas of learning among first-year medical students randomized to a patient- ... ...

Abstract	Purpose: Longitudinal patient-partnered experiences may promote medical student empathy, but evaluation of such programs is limited. The aim of this study was to compare areas of learning among first-year medical students randomized to a patient-centered track (PCT) or traditional track (TT) longitudinal clinical experience. Methods: PCT students (n=24) were paired with 2 patients and a physician to participate in their patients' care across multiple settings. TT students (n=56) were paired with a physician preceptor and participated in caring for a variety of patients in a single setting. This qualitative study used a phenomenological approach to template analysis, examining and comparing student reflective essays for areas of learning. Results: Three domains of learning emerged: 1) Focus of learning (biomedical, patient-centered); 2) Roles and relationships (clinical skills, relationship-building, teaching from preceptor and patients); and 3) Context of care (health systems science, interprofessional care). PCT students described patient-centered learning, relationship-building, and patients' role as teachers. In contrast, TT students emphasized biomedical learning, clinical skills development, and teaching from physician preceptors. Conclusions: Longitudinal patient-partnered clinical experiences provide rich opportunities for preclinical students to cultivate empathy and develop patient-centered values.
Language	English
Publishing date	2022-10-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	3022292-8
ISSN	2330-0698 ; 2330-068X
ISSN (online)	2330-0698
ISSN	2330-068X
DOI	10.17294/2330-0698.1930
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Article: Improving delirium care: prevention, monitoring, and assessment.

Kostas, Tia R M / Zimmerman, Kristin M / Rudolph, James L

The Neurohospitalist

2013 Volume 3, Issue 4, Page(s) 194–202

Abstract: Delirium is an acute change in awareness and attention and is common, morbid, and costly for patients and health care systems. While hyperactive delirium is easily identifiable, the hypoactive form is more common and carries a higher mortality. Hospital ... ...

Abstract	Delirium is an acute change in awareness and attention and is common, morbid, and costly for patients and health care systems. While hyperactive delirium is easily identifiable, the hypoactive form is more common and carries a higher mortality. Hospital systems to address delirium should consist of 3 critical steps. First, hospitals must identify patients who develop or are at intermediate or high risk for delirium. Delirium risk may be assessed using known patient-based and illness-based risk factors, including preexisting cognitive impairment. Delirium diagnosis remains a clinical diagnosis that requires a clinical assessment that can be structured using diagnostic criteria. Hospital systems may be useful to efficiently allocate delirium resources to prevent and manage delirium. Second, it is crucial to develop a systematic approach to prevent delirium using multimodal nonpharmacologic delirium prevention methods and to monitor all high-risk patients for its occurrence. Tools such as the modified Richmond Agitation and Sedation Scale can aid in monitoring for changes in mental status that could indicate the development of delirium. Third, hospital systems can utilize established methods to assess and manage delirium in a standardized fashion. The key lies in addressing the underlying cause/causes of delirium, which often involve medical conditions or medications. With a sustained commitment, standardized efforts to identify and prevent delirium can mitigate the long-term morbidity associated with this acute change. In the face of changes in health care funding, delirium serves as an example of a syndrome where care coordination can improve short-term and long-term costs.
Language	English
Publishing date	2013-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2629083-2
ISSN	1941-8752 ; 1941-8744
ISSN (online)	1941-8752
ISSN	1941-8744
DOI	10.1177/1941874413493185
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Article ; Online: Geriatrics training for nurses in a skilled nursing facility: a GWEP feasibility study.

Hawkley, Louise C / Long, Monica / Kostas, Tia / Levine, Stacie / Molony, Jason / Thompson, Katherine

Geriatric nursing (New York, N.Y.)

2017 Volume 39, Issue 3, Page(s) 318–322

Abstract: Geriatrics knowledge and expertise is critical to the care of older adults in skilled nursing facilities. However, opportunities for ongoing geriatrics training for nurses working in skilled nursing facilities are often scarce or nonexistent. This ... ...

Abstract	Geriatrics knowledge and expertise is critical to the care of older adults in skilled nursing facilities. However, opportunities for ongoing geriatrics training for nurses working in skilled nursing facilities are often scarce or nonexistent. This feasibility study describes a mixed-methods analysis of nurses' educational needs and barriers to continuing education in a for-profit skilled nursing facility in an underserved, urban environment. Potential mechanisms to overcome barriers are proposed.
MeSH term(s)	Aged ; Education, Nursing, Continuing ; Feasibility Studies ; Female ; Geriatric Nursing/education ; Humans ; Skilled Nursing Facilities ; Staff Development/methods ; Surveys and Questionnaires ; Vulnerable Populations
Language	English
Publishing date	2017-12-08
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	632559-2
ISSN	1528-3984 ; 0197-4572
ISSN (online)	1528-3984
ISSN	0197-4572
DOI	10.1016/j.gerinurse.2017.10.014
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