How well do physician and patient visit priorities align?

This study found that there is alignment between a patient's reason for a visit and the physician's main concern 69% of the time. Less than fully aligned priorities were associated with insurance status and the number of problems addressed.

Music therapy reduces pain in palliative care patients: a randomized controlled trial.

Context: Treatment of pain in palliative care patients is challenging. Adjunctive methods of pain management are desirable. Music therapy offers a nonpharmacologic and safe alternative.

Rapid reengineering of acute medical care for Medicare beneficiaries: the Medicare innovations collaborative.

In 2009 we described a geriatric service line or "portfolio" model of acute care-based models to improve care and reduce costs for high-cost Medicare beneficiaries with multiple chronic conditions. In this article we report the early results of the Medicare Innovations Collaborative, a collaborative program of technical assistance and peer-to-peer exchange to promote the simultaneous adoption of multiple complex care models by hospitals and health systems. We found that organizations did in fact adopt and implement multiple complex care models simultaneously; that these care models were appropriately integrated and adapted so as to enhance their adoptability within the hospital or health care system; and that these processes occurred rapidly, in less than one year.

In harm's way: Moving the older trauma patient toward a better outcome.

This century will bring an explosion in the geriatric population aged 65 and older, with those over 80 the fastest growing group. Falls, vehicle collisions, burns, and abuse are traumatic events that our geriatric patients may be susceptible to and from which they may not recover. Primary care providers should enhance their understanding of the complex issues of geriatric trauma to facilitate prevention and to assist the patient's recovery to normal function, addressing barriers such as immobility, pain, malnutrition, and acute confusion.

Geriatric outcomes are improved by a geriatric trauma consultation service.

Background: Traumatic injuries in older patients are complex and have significant impact on the individual, their family, and trauma centers. We hypothesized that greater attention to the timely identification and comprehensive management of comorbid conditions would improve outcomes in the care of the older injured patient.

Methods: This was a prospective, descriptive study of all patients 65 years of age and older admitted to the trauma service.