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Project ECHO:Extension for Community
Healthcare Outcomes at the BIDMC
Team ECHO-AGE
• Sheila Rhea-Nobles – Admin. Coordinator
• Angela Catic – Deputy Director
• Melissa Mattison – Deputy Director
• Lew Lipsitz – Team Director
• Dan Press – Team Neurologist
• Jason Strauss – Team Geriatrics Psychiatrist
Contact Info
Sheila : 617-632-8692
Fax: 617-632-8673
Logistics
• Twice monthly ECHO-AGE Clinics– Wednesdays, 11:30 am-1:30 pm
• First ECHO-AGE Clinic = June 13
Case Discussions
15 min Educational
Pearl
Select CaseFax
Template, Med List,
Clock Draw
TemplateMed List
Clock Draw
14d 7d
2d
1d
Order of Cases
Emailed
• Initial ECHO-AGE Clinic – Delirium and Dementia in short-term rehab
and long-term care
• Future ECHO-AGE Clinics:– Pain management– Falls/Syncope– Diabetes– Bone health
Select CaseFax
Template, Med List,
Clock Draw
TemplateMed List
Clock Draw
14d 7d
2d
1d
Order of Cases
Emailed
Template
• ECHO ID # will be assigned at the time of first presentation. Please include for follow-up case presentations.
• Bradykinesia - slowness of movement
• Rigidity – Dr. Press to explain
• Geriatric Depression Score
Clock Drawing
1. Ask patient to draw a clock like they would see on the wall
2. Place all the numbers on the face of the clock
3. Set the time for “10 minutes past eleven”
4. If patient cannot draw a circle, you may provide this, but please indicate this on the form
Continence
• Refers to urinary incontinence
• New fecal incontinence is important to note as well
Digit Span TestsForward:
815259496153913867276238426738931687354896215872397168243586591427538712469317954826
Backward:
5169582174729597355689171948153296417839371694891348724856312952843761
Normal Digit Span Forward ~7. Normal Digit Span Backward should not differ from Forward by more then 2 digits
Overall ECHO-AGE Evaluation
1. Operational
2. Educational
3. Patient Focused
4. System based
Ongoing assessmentto better meet your needs
Operational
• Satisfaction– PLEASE complete your survey from today’s
meeting and turn into Sheila before you leave
• Logistics
Educational
• Improved confidence caring for elders with delirium and dementia
• Knowledge gains regarding delirium and dementia diagnosis and management
*Patient Focused*
• Data collection - vital to success and expansion to other clinical topics
• Identify lead contact from your site to work with Sheila on data collection
• Data – Antipsychotic use– Admissions to acute care hospitals– Mortality– Social Engagement– Functional status (score calculated from MDS)
System Based Metrics
• Cost ($)
• Preventable transfers of care
• Quality metrics– Compliance with antipsychotic administration
and physical restraint guidelines
