SlideShare una empresa de Scribd logo
1 de 32
Reinventing the Nursing Home: Getting the Kind of Long-term Care We Want Robert L. Kane, MD University of Minnesota  School of Public Health
What is the Problem? ,[object Object],[object Object],[object Object]
 
The Problems with Current Thinking about LTC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of LTC Clients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What determines who should be cared for where? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Building Blocks of LTC ,[object Object],[object Object],[object Object],[object Object],[object Object]
Personal Care . Housing  Chronic Disease Care
Can’t Rely on a Name
Personal Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Housing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Care ,[object Object],[object Object],[object Object],[object Object]
Prerequisites  for  Making Good Decisions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Limited Treatment Options
Goals Clarification ,[object Object],[object Object],[object Object]
A Lot Depends on Interpretation
Potential LTC Goals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Merging Medical and  Social Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Developing Individualized Care Plans ,[object Object],[object Object],[object Object]
Role of Risk ,[object Object],[object Object],[object Object],[object Object]
Severity ,  i.e., cognition, function, prognosis. Preferences,  i.e., safety, autonomy, privacy, culture, atmosphere, aesthetics Personal Care Needs Health/ Clinical/ Medical Care Needs Housing Needs
Measuring Success in LTC ,[object Object],[object Object],[object Object]
Evidence of Successful LTC Observed Expected Outcome Time
Housing issues ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Personal Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Need Relevant Information
Information Technology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Glidepath ,[object Object],[object Object],[object Object],[object Object]
Clinical Glidepath Expected Course o o o X
How You Implement Is Important
Policy Issues ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Más contenido relacionado

La actualidad más candente

Medical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.LaszloMedical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.Laszlo
MedicineAndHealth
 
Patient- and Family Centered Care: "Resident Performance from the Patient's V...
Patient- and Family Centered Care: "Resident Performance from the Patient's V...Patient- and Family Centered Care: "Resident Performance from the Patient's V...
Patient- and Family Centered Care: "Resident Performance from the Patient's V...
hanscomhh5
 
Dental pateint relationship and technology
Dental pateint relationship and technologyDental pateint relationship and technology
Dental pateint relationship and technology
Iyad Abou Rabii
 

La actualidad más candente (20)

Doctor patient relationship
Doctor patient relationshipDoctor patient relationship
Doctor patient relationship
 
Advantage of the switching to concierge medicine
Advantage of the switching to concierge medicineAdvantage of the switching to concierge medicine
Advantage of the switching to concierge medicine
 
From disease-centered to patient-centered communication in breast cancer
From disease-centered to patient-centered communication in breast cancerFrom disease-centered to patient-centered communication in breast cancer
From disease-centered to patient-centered communication in breast cancer
 
Medical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.LaszloMedical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.Laszlo
 
Patient-Centered Communication: A Useful Clinical Review
Patient-Centered Communication: A Useful Clinical ReviewPatient-Centered Communication: A Useful Clinical Review
Patient-Centered Communication: A Useful Clinical Review
 
Patient centered care rvsd
Patient centered care rvsdPatient centered care rvsd
Patient centered care rvsd
 
iHT2 Health IT Summit in San Francisco 2013 - Dr. Sean Rogers, Medical Direct...
iHT2 Health IT Summit in San Francisco 2013 - Dr. Sean Rogers, Medical Direct...iHT2 Health IT Summit in San Francisco 2013 - Dr. Sean Rogers, Medical Direct...
iHT2 Health IT Summit in San Francisco 2013 - Dr. Sean Rogers, Medical Direct...
 
Ustun 2017 doctor patient relationship
Ustun 2017 doctor patient relationshipUstun 2017 doctor patient relationship
Ustun 2017 doctor patient relationship
 
Concierge Medicine: A Guide for the Risk-Averse Physician
Concierge Medicine: A Guide for the Risk-Averse Physician Concierge Medicine: A Guide for the Risk-Averse Physician
Concierge Medicine: A Guide for the Risk-Averse Physician
 
What's on the EHR Horizon for NZ Beyond 2014?
What's on the EHR Horizon for NZ Beyond 2014?What's on the EHR Horizon for NZ Beyond 2014?
What's on the EHR Horizon for NZ Beyond 2014?
 
Professional Opportunities In Health Psychology
Professional Opportunities In Health PsychologyProfessional Opportunities In Health Psychology
Professional Opportunities In Health Psychology
 
Putting Patient First Cynthia Kilroy PH Alliance Dec 11 2014
Putting Patient First  Cynthia Kilroy PH Alliance Dec 11 2014Putting Patient First  Cynthia Kilroy PH Alliance Dec 11 2014
Putting Patient First Cynthia Kilroy PH Alliance Dec 11 2014
 
Health & Productivity Solutions
Health & Productivity SolutionsHealth & Productivity Solutions
Health & Productivity Solutions
 
Patient- and Family Centered Care: "Resident Performance from the Patient's V...
Patient- and Family Centered Care: "Resident Performance from the Patient's V...Patient- and Family Centered Care: "Resident Performance from the Patient's V...
Patient- and Family Centered Care: "Resident Performance from the Patient's V...
 
Nursing Week
Nursing WeekNursing Week
Nursing Week
 
Chronic disease management
Chronic disease managementChronic disease management
Chronic disease management
 
An introduction to transitional care
An introduction to transitional careAn introduction to transitional care
An introduction to transitional care
 
Role of humanity and spirituality in medicine 
Role of humanity and spirituality in medicine Role of humanity and spirituality in medicine 
Role of humanity and spirituality in medicine 
 
Dental pateint relationship and technology
Dental pateint relationship and technologyDental pateint relationship and technology
Dental pateint relationship and technology
 
Medical Prognostication
Medical PrognosticationMedical Prognostication
Medical Prognostication
 

Similar a Reinventing The Nh

Behavioral Health Systems Lecture
Behavioral Health Systems LectureBehavioral Health Systems Lecture
Behavioral Health Systems Lecture
David Eisenman
 

Similar a Reinventing The Nh (20)

Community-based Chronic Care Management
Community-based Chronic Care ManagementCommunity-based Chronic Care Management
Community-based Chronic Care Management
 
What SNOMED CT® means to New Zealand
What SNOMED CT® means to New ZealandWhat SNOMED CT® means to New Zealand
What SNOMED CT® means to New Zealand
 
Behavioral Health Systems Lecture
Behavioral Health Systems LectureBehavioral Health Systems Lecture
Behavioral Health Systems Lecture
 
IBM Patient-Centered Medical Home Pre Launch Briefing
IBM Patient-Centered Medical Home Pre Launch BriefingIBM Patient-Centered Medical Home Pre Launch Briefing
IBM Patient-Centered Medical Home Pre Launch Briefing
 
Punch/Counter Punch: Biopsy of a Successful Integrated Care Program
Punch/Counter Punch: Biopsy of a Successful Integrated Care ProgramPunch/Counter Punch: Biopsy of a Successful Integrated Care Program
Punch/Counter Punch: Biopsy of a Successful Integrated Care Program
 
Ethical issues of elder Care
Ethical issues of elder CareEthical issues of elder Care
Ethical issues of elder Care
 
ETHICAL AND LEGAL ISSUES IN CARDIOVASCULAR AND THORACIC NURSING.pptx
ETHICAL AND LEGAL ISSUES IN CARDIOVASCULAR AND THORACIC NURSING.pptxETHICAL AND LEGAL ISSUES IN CARDIOVASCULAR AND THORACIC NURSING.pptx
ETHICAL AND LEGAL ISSUES IN CARDIOVASCULAR AND THORACIC NURSING.pptx
 
Social prescription presentation
Social prescription presentationSocial prescription presentation
Social prescription presentation
 
MPCA Integrating Healthcare Presentation
MPCA Integrating Healthcare PresentationMPCA Integrating Healthcare Presentation
MPCA Integrating Healthcare Presentation
 
Pulling It All Together March 6.09
Pulling It All Together   March 6.09Pulling It All Together   March 6.09
Pulling It All Together March 6.09
 
Harralson slides apos 2013 _web
Harralson slides apos 2013 _webHarralson slides apos 2013 _web
Harralson slides apos 2013 _web
 
Mental health integration 1
Mental health integration 1Mental health integration 1
Mental health integration 1
 
Advanced care planning Hospiscare
Advanced care planning   HospiscareAdvanced care planning   Hospiscare
Advanced care planning Hospiscare
 
Angela Coulter: Getting the best value for patients
Angela Coulter: Getting the best value for patientsAngela Coulter: Getting the best value for patients
Angela Coulter: Getting the best value for patients
 
Doctor Patient Relationship.ppt
Doctor Patient Relationship.pptDoctor Patient Relationship.ppt
Doctor Patient Relationship.ppt
 
Doctor Patient Relationship.ppt
Doctor Patient Relationship.pptDoctor Patient Relationship.ppt
Doctor Patient Relationship.ppt
 
Work Life Balance
Work Life BalanceWork Life Balance
Work Life Balance
 
The Healthcare Team as the Healthcare Provider: A Different View of the Patie...
The Healthcare Team as the Healthcare Provider: A Different View of the Patie...The Healthcare Team as the Healthcare Provider: A Different View of the Patie...
The Healthcare Team as the Healthcare Provider: A Different View of the Patie...
 
Payment Reform for Primary Care – Minnesota DHS efforts
Payment Reform for Primary Care – Minnesota DHS effortsPayment Reform for Primary Care – Minnesota DHS efforts
Payment Reform for Primary Care – Minnesota DHS efforts
 
Health Services.docx
Health Services.docxHealth Services.docx
Health Services.docx
 

Más de BCAGCP (7)

Evidence Based Approach To Falls 2008
Evidence Based Approach To Falls 2008Evidence Based Approach To Falls 2008
Evidence Based Approach To Falls 2008
 
Original Research
Original ResearchOriginal Research
Original Research
 
Suicide Prevention Toolkit Bcagcp Conf
Suicide Prevention Toolkit   Bcagcp ConfSuicide Prevention Toolkit   Bcagcp Conf
Suicide Prevention Toolkit Bcagcp Conf
 
Challenges and Changes in Home Care Presentation March 6-7 2009
Challenges and Changes in Home Care Presentation March 6-7 2009Challenges and Changes in Home Care Presentation March 6-7 2009
Challenges and Changes in Home Care Presentation March 6-7 2009
 
Update on Research in Geriatrics Presentation March 6-7 2009
Update on Research in Geriatrics  Presentation March 6-7 2009Update on Research in Geriatrics  Presentation March 6-7 2009
Update on Research in Geriatrics Presentation March 6-7 2009
 
A Home Care Practice That Works (For Syllabus)
A Home Care Practice That Works (For Syllabus)A Home Care Practice That Works (For Syllabus)
A Home Care Practice That Works (For Syllabus)
 
What To Do When Opioids Fail
What To Do When Opioids FailWhat To Do When Opioids Fail
What To Do When Opioids Fail
 

Último

Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
 

Último (20)

Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Top Rated Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
Top Rated  Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...Top Rated  Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
Top Rated Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Call Girls Visakhapatnam Just Call 8250077686 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 8250077686 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 8250077686 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 8250077686 Top Class Call Girl Service Ava...
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
 
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 

Reinventing The Nh