Category Archives: Strategic Planning

And now the video — Modern Gerontology By Michelle Bellantoni of Hopkins Presented at Collington

So, here it is:

For the slides, go here.

For Peter Fielding’s summary, go here.

I hope this changes both our personal health thinking, and the way our community plans and deploys health care.  The two, of course, will go together.  That’s the whole point of the strategic plan.

 

Summary of Michele Bellantoni’s Superb Modern Gerontology Presentation

A couple of weeks ago we were privileged to hear a presentation by Michelle Bellatoni, Director of Clinical Gerontology at Hopkins.

What an eye opener!

Her core goals for gerontology are, very simply:

  • Right care
  • Right time
  • Right place
  • Lowest cost
  • Highest quality
  • One Electronic Health Record

She earned our deep appreciation by telling us that she was going to use the same slides she uses with her medical students — which we took as a compliment.

Best of all, was her comment, at one point: “OK, lets roll up our sleeves and read some CT scans.”

More seriously, Peter Fielding, chair of our Health Service Committee, has drafted a five page summary, which is very well worth a full and careful read.  Here is summary in pdf. Full text of summary below.

We will soon be posting the video and the slides themselves.  All super useful as our strong health care commitment in the strategic planning process comes into clear focus.

 

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Collington Health Services Committee presents a talk entitled:

 MODERN GERIATRIC MEDICINE

Speaker: DR. MICHELE BELLANTONI, MD

Associate Professor, Division of Geriatric Medicine and Gerontology,

Johns Hopkins University School of Medicine 

HIGHLIGHTS and SUMMARY BY L. PETER FIELDING, MD

Michele Bellantoni visited Collington on Thursday, September 21, 2017. Marvell Adams (Collington’s Executive Director) toured with her the Creighton Center, the Clinic and our common areas at the Clock Tower before an informal lunch in our dining room. At 2 p.m., the auditorium was filled to capacity, the connection to our local TV channel was working and our resident-run film crew was ready to roll. The sound system was not great but serviceable.

After a few words of introduction, Michele Bellantoni launched into her talk, specifically geared to our seniors’ community but based on the same academic material used to discuss the specialty of Geriatric Medicine with the medical students at Johns Hopkins.

This Health Services talk was longer than usual (75 minutes!) but the audience attention was maintained throughout. The Q and A session lasted 20 minutes, but could have gone on much longer. Afterwards many people came up to chat informally such that our speaker did not leave until 4 p.m. The purpose of this report is to summarize the content of Dr. Bellantoni’s talk and emphasize her “take-home” messages.

The issues of aging include: cognitive health; emotional health; mobility; nutrition; hormones; fragility; cardiovascular health; immunity and end of life issues. Each may contribute to or detrract from life expectancy and quality of life.

  • Comparison to Europe

The overall longevity is greater in Europe than in the USA in ALL of the following categories of disease: heart disease; stroke; lung disease; diabetes; hypertension and cancer.

  • Comorbid conditions

The increased occurrence of current medical conditions (comorbidity) in the seniors’ population in the USA helps to explain these life expectancy differences.

  • Body-mass index (BMI)

The relationship between height and body weight, from which the BMI is calculated, has had a rapid deterioration in recent decades resulting in a great increase in obesity frequency. Thus, a rising BMI is a major cause of the increase of comorbidity in the USA and its consequential decrease in our life expectancy.

>Take home message: Focused attention on diet, nutrition and exercise are key factors to reduce BMI and therefore the prevalence of co-morbid conditions which may then increase an individual’s life expectanc

Life span varied by zip code in the Baltimore area highlighting the relationship between the socioeconomic condition of patients and their longevity. Substantial differences in clinical outcomes were observed for highly treatable conditions indicating that diminished access to healthcare is very important to preserving life span.

>Take home message: Improved access to healthcare must become a major goal with active outreach programs geared towards prevention and preemption strategies. Such programs have demonstrated: a reduced need for hospital care consultation; a reduced frequency of emergency department visits; decreased readmission after hospital discharge; and reduced complication rates when comorbid conditions are treated.

 The observed increased frequency of all forms of dementia, in recent decades, has many causes. The following items in bold are associated with increased dementia frequency; possible mitigating strategies are suggested.

  • Increased amyloid plaques in the brain is associated with Alzheimer’s disease. Cause unknown; specific treatment none.
  • Increased BMI. Caloric restriction favors longevity with 1800 Cals/day being the estimated optimum.
  • Increased stress. Stress reduction strategies: restorative sleep; exercise; meditation.
  • Diminished immunological function. Maintenance of immunological function with vaccinations for influenza, pneumonia, herpes zoster & tetanus/pertussis.
  • Reduced social interaction. High-intensity volunteering activity provides an opportunity to care for others.
  • General Principles:

               Right care

               Right time

               Right place

               Lowest cost

               Highest quality

              One Electronic Health Record

  • These broad goals can be achieved by:

Coordinated system of healthcare, including patient advocates and navigators.

Patient portal for communication

24-hour physician access

Collection of data for measures of clinical quality

Integration with a team approach between primary and secondary care.

  • Components of the J.H. program:

Activities of daily living (ADL) support

Chronic disease management

Coordination with acute hospital services

Daycare program

Fall prevention

Medication management

Multi-morbidity management

Oral & dental care

Preventive health

Specific post-acute service follow-up

Vision and hearing support,

            Wellness program

 

  • Principles of care

Genes only determine 25% of our life span

Remaining 75% requires coordinated care in multiple settings

Major emphasis on clinical outreach

Advanced Directives documentation

 

  • Preventive care:

Dementia

Diet and nutrition

Fall prevention

Oral and dental care

Osteoarthritis and osteoporosis

Screening for cancer

Vaccinations

Vision and hearing support

  • Pre-emptive care:

Active medical issues prioritization

Coordination of specialist care

Effective communication

Medical access 24/7

Medication management

  • Palliative care:

All of the above, but geared to symptom management to maximize quality of life for the individual’s physical and psychosocial needs and wellbeing.

  • Passing (end of life) care. (These items added by LPF)

Role of food and water management

Pa in management and use of sedatives/anxiolytics

Hospice support for patients and family

 

 

Major Rehab Upgrade

As a partial consequences on our long term planning, Collington is making a major upgrade to our rehab services.  The new group that will be providing rehab services is Assisted Rehab.

Here is the schedule of introductions and meetings, which as see, shows a real intent on all sides to build a partnership that reflects our needs down to the individual level.

FOR ALL RESIDENTS

September 15 at 1:30pm – Resident Community Meeting – Auditorium Meet the Leadership of Assisted Rehab

• Overview of company, background and expertise as well as their philosophy on rehabilitation and resident-centered care.

September 19 at 2:30pm – Health Services Coffee Chat – Auditorium

Experience Assisted Rehab’s Philosophy of Care

  • Informal discussion of what residents can expect for the rehabilitation process and the types of services provided
  • A short but energetic example of how to “get moving” and active again

August 31, 2017

September 28 at 3:30pm – Health Center Resident’s Meeting –– Arbor Great Room

Understand Assisted Rehab’s Approach in Meeting the Unique Care Needs of Health Center Residents

  • Overview of company and what benefits it can bring to residents of the health center
  • A short but energetic example of how to “get moving” and active again.

 

October at Various Dates/Times – District Rounds – Various Locations

• Smaller group meetings with each resident housing district to answer additional questions and share more details on the transition and specifics on programming.

FOR HEALTH SERVICES STAFF MEMBERS

September at Various Dates/Times – Staff Meetings

• Meetings with health services team to review final logistics of transition, overview of processes and needs of both Collington and Assisted Rehab

From talking to those who participated in the select5ion process, it seems that we have an energetic, committed, partner, who cares about individuals and innovation.

Above all, this change should make it much easier to integrate approaches that are about life goals, not just vital sign metrics.  We will be seeing more and more changes that mutually reinforce each other.  As a tweetet might say, “EXCITING.”

Watch this space.

 

The Collington Silt Warriors

Wall Pic 3

Karen Boyce launched our reporting on the silt amelioration project with this photo and the below information about the group that is spearheading the work:

The Clean Water Partnership is a Public-Private Partnership (P3) between Prince George’s County and Corvias. The CWP is the first of its kind to design, build, finance, operate and maintain urban stormwater infrastructure to meet MS4 regulatory requirements and is committed to retrofit up to 4,000 impervious acres.

Please visit www.thecleanwaterpartnership.com to learn more about this innovative partnership.

So your investigative team, soil and water expert Jacob Kijne and I, wandered down and gathered more provisional information — and some more photos, about this important work.

The idea is that the incoming silt-laden water is slowed down by the rocks, and drops its load of silt into the area between the inlet and the rocks.  The rocks, by the way, are kept in “cages” of PVC coated cable, so the containers will not rot.  Every few years, the trapped silt can easily then be removed.  The rocks will be much less visible than now, since they should be largely covered by water one water is allowed back into the lake.

Obviously, we can not plant trees directly onto the rocks, but maybe we will be able to think of some ways that we can use the new feature as an opportunity.  Maybe we need a “Lake Group,” just like we have a “Courtyard Group.”  Time for some Collington creativity.  Part of the opportunity is to think about how we can apply the emerging goal and value themes of the strategic planning process to an exploration of the lake’s potential — boat trips for staff kids, sustaining our water?  Educational programs from our experts?  More ideas?  It is perfect that our new horticulturalist will be onboard soon and can help us think about the relationship between our values and our landscape resources.

More photos:

 

 

 

Collington ED on Helping Harvey Victims and Beyond

Here is Marvell Adams statement.

Among other things, it shows the where the heart of this community lies and the value of being part of a larger community.  It also suggests some of the ways that emerging themes in our strategic planning process will deepen our ability to add to, in the words of the Kendal Values Statement, “the potential for fulfillment and continuing contribution during the later stages of life.”

Greetings Friends.  Undoubtedly you have all seen the tragic images coming out of Texas as a result of Hurricane Harvey. 

I am certain we all share in the heartache being experienced there right now.  As an organization committed to serving older adults, Collington and the Kendal System have a duty to respond when events such as these occur and greatly impact communities that share in our mission.  As such, Kendal has collaborated with LeadingAge, our national provider association of which I’m a board member, to provide assistance.  First and foremost, donations are needed in order to provide supplies and support for residents and staff of affected communities.  Each of us can help this effort by visiting Collington’s website, www.collington.kendal.org  and donating to the LeadingAge Hurricane Harvey Disaster Relief Fund.  There is a link there that will allow you to make an online donation as well as instructions on how to send in a check.  All proceeds will go directly to member communities, their residents and staff.

Secondly, Kendal has reached out to communities we assisted in New Orleans after Hurricane Katrina in order to understand what might be the most helpful for our friends in Texas.  With this feedback and that of LeadingAge, the Kendal System will develop ways to provide further support beyond donations.  When we have more details on this I will share.  In the meantime, please keep those affected by Hurricane Harvey in your thoughts and consider making a donation to the LeadingAge Hurricane Harvey Disaster Relief Fund.  Thank you.