Last week, the Journal of the American Medical Association (JAMA) published a large and well-designed study of a post-hospital readmission reduction program called the “virtual ward,” which grew up in the UK and was tested by our cousins to the north in Toronto.
The model partakes of some elements of other evidence-based work done by John A. Hartford Foundation grantees, including Mary Naylor’s Transitional Care Model, the Society of Hospital Medicine’s Project BOOST, and Eric Coleman’s Care Transitions Intervention.
A press release and JAMA Report video are available for those who don’t subscribe to JAMA.
Kathryn Dineen Wriston, right, with her beloved husband Walter B. Wriston, circa early 1990s. (Photo A)
Kathy Wriston was an elegant and accomplished woman whose delightful sense of humor and natural openness drew others to her—and to the causes she passionately supported. She will be sorely missed.
Her death at age 75 on Sept. 28, 2014 due to complications from a fall at her home in Sherman, CT, came as a shock to all of us who were fortunate enough to know Kathy, and leaves us with a profound sense of loss.
I think it would be safe to say that most of us have trouble facing our own mortality. The idea that tomorrow isn’t promised fails to get many of us to actually live that way (I know I’m guilty).
Longer term and more connected to the John A. Hartford Foundation’s work, we don’t like to think of ourselves as “old”—let alone dying—and we don’t plan well for futures that will likely include the need for long-term care or services later in life.
Our health care system and policies reflect this short sightedness, as well. That’s why it’s been refreshing to see some provocative writing about these issues over the past few weeks that might help us all think and do more to live our final years in old age the way we would want.
Last week, the Institute of Medicine released a new report titled Dying in America.
The committee that worked on the report included some long-time grantees and friends of the John A. Hartford Foundation, such as June Simmons of the Partners in Care Foundation, Jean Kutner, a Beeson Scholar and faculty member at the University of Colorado, Diane Meier, leader of the Center to Advance Palliative Care, Patricia Bomba of Rochester, NY’s Excellus Blue Cross/Blue Shield, and Joan Teno of the Center of Excellence in Geriatric Medicine at Brown University.
As always, we are proud to be associated with leaders who give their time to explore such urgent issues.
Hartford Trustees Kathryn D. Wriston, left, and Lile R. Gibbons, at a recent reception honoring them as personal supporters of the MSTAR program.
Over the past 20 years, the Medical Student Training in Aging Research (MSTAR) program—a summer internship that draws physicians-in-training into the field of geriatrics and aging research—has supported more than 2,000 medical students.
We celebrated the program’s 20th anniversary and its remarkable record last week with a reception honoring John A. Hartford Foundation Trustees and other individuals who have personally donated to the sustainability of this initiative, administered by the American Federation for Aging Research (AFAR).
Many of the John A. Hartford Foundation’s grant projects are working hard to improve the quality of health care for the older adults who are dually enrolled in both Medicare and Medicaid.
As a group, these low-income, older adults have more complex health conditions and a greater need for coordinated, geriatrics-expert care that meets their own individualized health goals.
To improve quality and reduce costs in this population, states are working with the federal government and local managed care health plans to integrate the financing and care delivered through Medicare and Medicaid. Changes are happening fast as states experiment with delivering care to this population of “duals” through these health plans, many of which have never had experience caring for an older adult population with complex conditions.
Since launching our Hartford Change AGEnts initiative late last year, we’ve taken the first steps toward our goal of accelerating sustained practice change that improves the health of older Americans, their families, and communities.
Change AGEnts are connecting through our online community and the first two Change AGEnts Networks—focused on patient-centered medical homes and dementia caregiving—are already hard at work. We’ve funded nine Change AGEnts Action Awards and are currently accepting applications for our second cohort, and we’ve awarded collaborative pilot grants in partnership with the Change AGEnts program for our Centers of Excellence Scholars and for Beeson Scholars.
The initiative’s leadership team and our partners at the Gerontological Society of America (GSA) are working hard to support the Change AGEnts community and are ready and willing to help people engage. Since we get lots of questions about how people can get involved, we thought that addressing them in a Q&A would be helpful and highlight some immediate opportunities.
Ever since I began working as a program officer at the John A. Hartford Foundation, I’ve tried to do my best to put myself in the shoes of the health professionals with whom we’ve worked and whose education and training historically has been one of our main concerns.
I’ve often found memoirs and other lightly fictionalized accounts to be the best way to get into the culture and daily experience of these health professionals. I’ve read Samuel Shem’s The House of God, countless memoirs of nurses and physicians, and even a very affecting memoir of a nurse’s aide in a nursing home.
One of the tricks of such reading is that we experience what our imagination and the author’s words together conjure in a special state of willing suspension of disbelief. Psychological research suggests that this process of imagination and purposeful lowering of critical skepticism is, in fact, what makes fiction so persuasive and engenders the feeling that novelists understand a truth about human character that other ways of knowing can’t match.