Teleconference is lifeline to better care for Northwest's seniors

UW's family-medicine residents have weekly access to guidance on managing elder patients' conditions.

On the third Friday of the month, a team of geriatric specialists gathers over lunch at Harborview Medical Center. In a small room, they lead a teleconference that is one of the Pacific Northwest’s most concerted efforts to improve care of elderly people.

That exponentially growing population faces a scarcity of physicians well qualified to treat the constellation of problems that burden seniors. Only 3 percent of medical students nationwide take even one class in geriatrics.

The virtual meeting’s main audience is UW’s Family Medicine Residency Network – residents doing their clinical rotations in Washington, Wyoming, Alaska, Montana, and Idaho. “These are family medicine residents, they’re very smart, and we want to make them more expert in the health of older adults,” said Dr. Katherine Bennett.

picture of Dr. Kevin Braun
The teleconferences present valuable context, said Olympia-based physician Kevin Braun.

She leads Project ECHO – Geriatrics, which began in January 2016. Each month, one of the specialists teaches on a preselected topic – say, medication perils or fall prevention or screening a patient’s capacity to drive – followed by discussion. Then one of the 30 or so participants formally presents a patient case and gets guidance from the team.

The 60-minute teleconferences are an immeasurable resource, participants say.

“My residents present their patient conundrums and get recommendations about pharmaceutical and behavioral management, disease prevention and health promotion,” said Dr. Kevin Braun. He mentors UW residents at Providence St. Peter Family Medicine in Olympia. “Geriatrics is unique in that every decision you make is guided not just by clinical guidelines, but by a discussion with the patient and family of what should you do, in terms of life expectancy and quality. The residents get perspective about managing in that way.”

Feedback emerges from not only the Harborview panel but also from the experiences of other Project ECHO participants. The teaching portion of each session also is archived online.

The course is a modest but meaningful step, Bennett said. “When I hear a resident present using the knowledge or skills they learned in a previous session – considering how sick and how functional a patient is. That tells me they’re seeing care through a new lens.”

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Tags:educationgeriatrics and gerontology

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