High-quality community needs assessments can help focus limited resources on the needs of a rapidly expanding population-older Americans. Based on such assessments, organizations and communities can effectively plan and deliver cost-effective, appropriate health promotion/wellness programs and health/social services to targeted populations. This article, which describes the Arkansas Aging Initiative's (AAI) use of a community needs assessment to identify its constituents' top health needs, provides specific background information for communities with demographics similar to those in Arkansas and offers assessment strategies for communities throughout the US. The AAI used two complementary methodologies to obtain critical input from Arkansas providers and their communities: focus groups of healthcare providers and community members and surveys administered to older adults. The assessment confirmed that health problems in the communities were consistent with leading causes of morbidity and mortality at state and national levels. It indicated that respondents' top three health needs related to affordability, including affordability of prescription medications, medical care, and health insurance, and that needs varied inversely with age. In other findings, married individuals rated their own health as better than their single counterparts; whites rated their health better than non-whites; and more than half of respondents reported leaving their counties to receive healthcare. This community needs assessment has enabled the AAI to address respondents' needs by developing specific educational and interdisciplinary healthcare initiatives, such as increasing access to a prescription drug assistance program.
The Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences in Little Rock is addressing one of the most pressing policy issues facing the United States: how to care for the burgeoning number of older adults. In 2001, the Institute created the Arkansas Aging Initiative, which established seven satellite centers on aging across the state using $1.3 to $2 million dollars annually from the state's portion of the Master Tobacco Settlement. These centers on aging assist the state's population of older adults, many of whom reside in rural areas, live in poverty, and suffer from poor health. The centers provide multiple avenues of education for the community, health care providers, families, and caregivers. The Arkansas Aging Initiative, in partnership with local hospitals, also makes geriatric primary and specialty care more accessible through senior health clinics established across rural Arkansas. In 2005, older adults made more than 36,000 visits to these clinics. All sites have attracted at least one physician who holds a Certificate of Added Qualifications in geriatrics and one advanced practice nurse. Other team members include geriatric medical social workers, pharmacists, nutritionists, and neuropsychologists. This initiative also addresses other policy issues, including engaging communities in building partnerships and programs crucial to maximizing their limited resources and identifying opportunities to change reimbursement mechanisms for care provided to the growing number of older adults. We believe this type of program has the potential to create a novel paradigm for nationwide implementation.
The 4Ms Age-Friendly Framework has been introduced and implemented into nearly 2,000 primary care practices across the United States by Geriatric Workforce Enhancement Program’s (GWEP) educational efforts. The AR Geriatric Education Collaborative, the GWEP in Arkansas, has provided monthly trainings to a rural federally qualified healthcare clinic system and educated clinicians about how to complete a Medicare Annual Wellness Visit (AWV) that was inclusive of an advance care plan. Specific educational training including the two main components of an ACP: living will preferences and medical power of attorney were reviewed as their role into “What Matters” was explained. Before 4Ms Age Friendly training, baseline data showed only 7% of older adults (OAs) had an established ACP in site 1 and 33% in site 2. After training, the rate of ACP rose to 47% in site 1 and 59% in site 2. During the training, not only were the two main components reviewed but case studies were provided about what questions to ask surrounding the “What Matters” question as a guide to further discuss an OAs wishes, priorities and end-of-life care. This project demonstrated that implementation of 4Ms Age-Friendly Care not only improves the completion of advance care plans but also further enhances the overall care of the older adult when “what matters” most to the older adults is known and communicated.
Embodied nursing knowledge and its effects on patient outcomes are understudied in home health. The researchers performed a descriptive correlational study, in nine home health agencies in Ohio, to consider the effects of embodied nursing knowledge in expert practice in 107 registered nurses working in Medicare certified home health agencies. While statistical significance was not noted, findings of this study add to the understanding or research and the outcome improvement scores in home health. Findings also pose the question that the concepts used in acute care to improve mortality rates and patient outcome improvements may be different in home health.
Are hospital-based outpatient interdisciplinary clinics a financially viable alternative for caring for our burgeoning population of older adults in America? Although highly popular, with high patient satisfaction rates among older adults and their families, senior health clinics (SHCs) can be expensive to operate, with limited quantifiable health outcomes. This study analyzed three geriatric hospital-based interdisciplinary clinics in rural Arkansas by examining their patient profiles, revenues, and expenses. It closely examined the effects of the downstream revenue using the multiplier effect and acknowledged other factors that weigh heavily on the success of SHCs and the care of older adults. The findings highlight the similarities and differences in the three clinics' operating and financial structures in addition to the clinics' and providers' productivity. The analysis presents an evidence-based illustration that SHCs can break even or lose large amounts of money.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.