60 Seconds with... Dr. Eric Coleman, associate professor of geriatric medicine at the University of Colorado
Q: In your research on transition issues, you note there is "tension" between nursing homes and hospitals. Why is this so? A: There unquestionably are culture differences between the way care is given in each setting. They focus on different things. They almost need a translator when nursing homes start talking about pressure ulcers. Also, things like pain scales are applied differently.
Q: How do problems show?
A: The most frightening and visible are medication errors. Some of it is hospitals reflexively adding more medications. A second thing is hospitals are less aware of appropriate medication selection for older patients, particularly the cognitively impaired. The third is trying to reconcile the medications – hospital and nursing home formularies can differ.
Q: What would help?
A: Can nursing homes and hospitals agree on a standard transfer form? It's more involved than people can imagine because they're so culturally different. Nursing homes want cognitive function and skin integrity information.
Q: What else?
A: We need a discharge summary to make it a living document that speaks to the next care team. Hospitals need to prepare for a receiving team more.
Q: What would help communications?
A: Looking at the way information can be shared electronically. Mostly, nursing homes don't have capital to make a big investment.
Q: Where can providers learn more?
A: The Care Transition Program at the University of Colorado Health Services Center. Go to www.caretransition.org.