2017 AMDA Conference

Telemedicine is rapidly becoming a standard of care in modern medicine. By increasing access and responsiveness to care, telemedicine can improve clinical outcomes, reduce costs, and increase provider, patient, and family satisfaction. Despite these potential benefits, the technology and the requisite changes that it brings are relatively new in the PA/LTC setting. Many health care providers and leaders have expressed the need to build their knowledge and skills to reap the full potential value of this innovation. This half-day workshop will build attendee’s knowledge and skills in the standards for telemedicine care in PA/LTC through engaging lectures, roundtable interactive examples of telemedicine from PA/LTC settings, and facilitated discussions. Learners will leave with practical skills that are needed to “get started,” to advanced skills such as making the financial case for telemedicine in their PA/LTC system, to ensure that their program has the care processes and technology to accomplish their goals.

Learning Objectives:
(1) Discuss the opportunities to use telemedicine to enhance PA/LTC.
(2) Identify technical and environmental considerations for high quality telemedicine in PA/LTC.
(3) Develop a strategy for establishing telemedicine services in their practice or medical group.

This session will review the components of the Serious Illness Program, an evidence-based, patient tested, structured approach to serious illness conversation. Participants will practice using the serious illness conversation guide and will receive feedback and advice for implementing the technique in patient care.

Learning Objectives:
(1) Recognize the need for a systematic evidence-based approach to discussing goals and values with seriously ill patients.
(2) Describe the seven steps of the Serious Illness Conversation.
(3) Demonstrate use of the Serious Illness Communication Guide to elicit preferences and patient goals of care.
(4) Provide feedback related to observed skills/techniques that facilitate exploratory conversations with patients and family members.

Building on feedback from attendees at the 2017 Annual Conference and recent literature, this session will focus on mentorship for those working with PA/LTC teams and administration. Effective mentorship is critical to the success of all health care professionals, but especially those in leadership positions. Mentorship is a two-way street. Being an effective, thoughtful mentor is challenging, and so is being a proactive, engaged mentee. This session will offer brief didactics on mentorship. Interactive and facilitated roundtables will help attendees develop skills for establishing and sustaining meaningful mentoring relationships. The session will also offer attendees opportunities to build their professional network.

Learning Objectives:
(1) Discuss the importance of mentoring relationships on professional development.
(2) Create a personal action plan to engage mentors in their own institution or those mentors encountered on a national level.
(3) Identify strategies to promote effective, successful mentoring relationships.

The purpose of this session is to present a diverse panel of experts who will discuss the development of programs, policies, and clinical interventions at the Hebrew Home at Riverdale involving sexual expression and medical marijuana. This is a very unique opportunity for conference attendees to gain the perspectives of a CEO, CMD, and LTC consulting attorney in a fascinating 90-minute session that should not be missed.

Learning Objectives:
(1) Describe three novel programs at the Hebrew Home of Riverdale which may be used as models for change in participant facilities.
(2) Discuss strengths and limitations to use of medical marijuana in LTC.
(3) Review current or pending legislation which may impact the use of medical marijuana in LTC.
(4) Discuss leadership skills which facilitate change in the LTC environment.

This session, presented by an attorney, bioethicist, and a long time medical director, will detail and reinforce the use of the interprofessional bioethics committee format in skilled nursing facilities, with a specific eye toward promoting resident-centered care and autonomy, and taking into account risk management principles. The session will also review determination of decisional capacity, and includes content on working with incapacitated, unrepresented patients. In addition to didactic content, case presentations and small group discussion will be utilized.

Learning Objectives:
(1) Implement an interprofessional ethics evaluation framework to support resident-centered care decisions in PA/LTC, including the medical director as a vital participant.,
(2) Assess decision-making capacity for nursing home residents with respect to a variety of situations. ,
(3) Apply the principles of bioethics to direct resident-centered care in light of risk management concerns.,
(4) Formulate strategies to improve medical decision-making for incapacitated unbefriended (unrepresented) nursing home residents.

The Center for Medicare & Medicaid Services (CMS) issued a comprehensive reform of the requirement for LTC facilities to participate in Medicare and Medicaid programs. This session will review the changes relevant to infection prevention and control and antibiotic stewardship, from the perspectives of an infection preventionist, a consultant pharmacist, and an infectious disease physician.

Learning Objectives:
(1) Discuss the infection preventionist’s role and responsibilities indicated in the 2016 Reform of Requirements of Participation.
(2) Review the pharmacy services and the consultant pharmacists’ expanded role in infection prevention and control and antibiotic stewardship programs.
(3) Describe basic components of an antibiotic stewardship program, including an antibiotic stewardship policy and antibiotic use protocols appropriate for PA/LTC settings.

JAMDA is the official journal of AMDA – the Society for Post-Acute and Long-Term Care Medicine. In this session, the journal’s new Co-Editors-in-Chief – Philip Sloane, MD, MPH, and Sheryl Zimmerman, PhD, will present their vision, discuss the manuscript submission and review process, and invite comments and suggestions from attendees.

Learning Objectives:
(1) Explain the purposes and mission of JAMDA – The Journal of PA/LTC Medicine.
(2) Discuss the vision and proposed expanded emphases under the new editors-in-chief.
(3) Describe principles of successful authorship and manuscript review.

This session will discuss the epidemiology, classification, risk factors, and pathophysiology of urinary incontinence (UI) and fecal incontinence (FI) in persons living in the PA/LTC environment. The talk will cover evidence-based recommendations for assessment, treatment, and management of these conditions within the framework of patient-centered goals of care in PA/LTC. Pharmacologic and non-pharmacologic treatment strategies will be reviewed. Psychosocial implications of UI and FI and the importance of patient-provider communication will be highlighted. Interactive case-based scenarios will be utilized. Innovative and emerging treatment techniques such as tibial neuromodulation and a patient-learning community research project will also be presented. < br />
Learning Objectives:
(1) Describe the epidemiology, risk factors, classification, and pathophysiology of urinary and fecal incontinence in the PA/LTC environment.
(2) Discuss evidence-based recommendations for the assessment of urinary and fecal incontinence in the context of patient-centered care in PA/LTC.
(3) List pharmacologic and non-pharmacologic treatment strategies for urinary and fecal incontinence in older adults in the PA/LTC continuum.
(4) Describe patient-oriented goals of care for the interprofessional management and improvement of quality of life for persons with urinary and fecal incontinence in PA/LTC.