Literature DB >> 23486816

The IMPACT clinic: innovative model of interprofessional primary care for elderly patients with complex health care needs.

C Shawn Tracy1, Stephanie H Bell, Leslie A Nickell, Jocelyn Charles, Ross E G Upshur.   

Abstract

PROBLEM ADDRESSED: The growing number of elderly patients with multiple chronic conditions presents an urgent challenge in primary care. Current practice models are not well suited to addressing the complex health care needs of this patient population. OBJECTIVE OF PROGRAM: The primary objective of the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic was to design and evaluate a new interprofessional model of care for community-dwelling seniors with complex health care needs. A secondary objective was to explore the potential of this new model as an interprofessional training opportunity. PROGRAM DESCRIPTION: The IMPACT clinic is an innovative new model of interprofessional primary care for elderly patients with complex health care needs. The comprehensive team comprises family physicians, a community nurse, a pharmacist, a physiotherapist, an occupational therapist, a dietitian, and a community social worker. The model is designed to accommodate trainees from each discipline. Patient appointments are 1.5 to 2 hours in length, during which time a diverse range of medical, functional, and psychosocial issues are investigated by the full interprofessional team.
CONCLUSION: The IMPACT model is congruent with ongoing policy initiatives in primary care reform and enhanced community-based care for seniors. The clinic has been pilot-tested in 1 family practice unit and modeled at 3 other sites with positive feedback from patients and families, clinicians, and trainees. Evaluation data indicate that interprofessional primary care models hold great promise for the growing challenge of managing complex chronic disease.

Entities:  

Mesh:

Year:  2013        PMID: 23486816      PMCID: PMC3596224     

Source DB:  PubMed          Journal:  Can Fam Physician        ISSN: 0008-350X            Impact factor:   3.275


  14 in total

1.  Can family physicians practise good medicine without following clinical practice guidelines? Yes.

Authors:  Ross E G Upshur
Journal:  Can Fam Physician       Date:  2010-06       Impact factor: 3.275

2.  Interprofessional collaboration in family health teams: An Ontario-based study.

Authors:  Joanne Goldman; Jamie Meuser; Jess Rogers; Lynne Lawrie; Scott Reeves
Journal:  Can Fam Physician       Date:  2010-10       Impact factor: 3.275

3.  Potential pitfalls of disease-specific guidelines for patients with multiple conditions.

Authors:  Mary E Tinetti; Sidney T Bogardus; Joseph V Agostini
Journal:  N Engl J Med       Date:  2004-12-30       Impact factor: 91.245

Review 4.  Chronicity and complexity: is what's good for the diseases always good for the patients?

Authors:  Ross E G Upshur; Shawn Tracy
Journal:  Can Fam Physician       Date:  2008-12       Impact factor: 3.275

5.  The way we do things around here: advancing an interprofessional care culture within primary care.

Authors:  Ivy F Oandasan
Journal:  Can Fam Physician       Date:  2009-12       Impact factor: 3.275

6.  Chronic health conditions: changing prevalence in an aging population and some implications for the delivery of health care services.

Authors:  Frank T Denton; Byron G Spencer
Journal:  Can J Aging       Date:  2010-03

7.  Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance.

Authors:  Cynthia M Boyd; Jonathan Darer; Chad Boult; Linda P Fried; Lisa Boult; Albert W Wu
Journal:  JAMA       Date:  2005-08-10       Impact factor: 56.272

8.  The assessment and treatment of a complex geriatric patient by an interprofessional primary care team.

Authors:  Stephanie H Bell; C Shawn Tracy; Ross E G Upshur
Journal:  BMJ Case Rep       Date:  2011-03-15

9.  From pharmaco-therapy to pharmaco-prevention: trends in prescribing to older adults in Ontario, Canada, 1997-2006.

Authors:  Jana M Bajcar; Li Wang; Rahim Moineddin; Jason X Nie; C Shawn Tracy; Ross Eg Upshur
Journal:  BMC Fam Pract       Date:  2010-10-07       Impact factor: 2.497

10.  Measuring change in health status of older adults at the population level: the transition probability model.

Authors:  Rahim Moineddin; Jason X Nie; Li Wang; C Shawn Tracy; Ross E G Upshur
Journal:  BMC Health Serv Res       Date:  2010-11-09       Impact factor: 2.655

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  26 in total

1.  Trends in nurse practitioners' prescribing to older adults in Ontario, 2000-2010: a retrospective cohort study.

Authors:  Joan E Tranmer; Lindsey Colley; Dana S Edge; Kim Sears; Elizabeth VanDenKerkhof; Linda Levesque
Journal:  CMAJ Open       Date:  2015-07-17

2.  Interdisciplinary Practice Models for Older Adults With Back Pain: A Qualitative Evaluation.

Authors:  Stacie A Salsbury; Christine M Goertz; Robert D Vining; Maria A Hondras; Andrew A Andresen; Cynthia R Long; Kevin J Lyons; Lisa Z Killinger; Robert B Wallace
Journal:  Gerontologist       Date:  2018-03-19

3.  Effect of an innovative model of complexity care on family caregiver experience: Qualitative study in family practice.

Authors:  Leslie A Nickell; C Shawn Tracy; Stephanie H Bell; Ross E G Upshur
Journal:  Can Fam Physician       Date:  2020-03       Impact factor: 3.275

4.  Polypharmacy: prevention and management.

Authors:  C Shawn Tracy; Jonathan Fuller; Ross E G Upshur
Journal:  CMAJ       Date:  2014-11-18       Impact factor: 8.262

5.  From clinical observation to clinical discovery: the challenge for family medicine research.

Authors:  Nicholas Pimlott; Ross E G Upshur
Journal:  Can Fam Physician       Date:  2014-01       Impact factor: 3.275

6.  Connecting People With Multimorbidity to Interprofessional Teams Using Telemedicine.

Authors:  Pauline Pariser; Thuy-Nga Tia Pham; Judith B Brown; Moira Stewart; Jocelyn Charles
Journal:  Ann Fam Med       Date:  2019-08-12       Impact factor: 5.166

7.  Effect of comorbidities and medications on frequency of primary care visits among older patients.

Authors:  Tina Hu; Neil D Dattani; Kelly Anne Cox; Bonnie Au; Leo Xu; Don Melady; Liisa Jaakkimainen; Rahul Jain; Jocelyn Charles
Journal:  Can Fam Physician       Date:  2017-01       Impact factor: 3.275

8.  Still dizzy after all these years: a 90-year-old woman with a 54-year history of dizziness.

Authors:  Alina Smirnova; Stephanie H Bell; C Shawn Tracy; Ross E G Upshur
Journal:  BMJ Case Rep       Date:  2011-09-13

9.  A concerning trend in geriatric pharmacy that merits evidence-based intervention.

Authors:  Hunter Merritt Hughes; Hamasah Nizami; Juan Sebastian Polanco; Jessica Poulson; Alice Cai; Rea Mittal; Lilly Su; Pranjal Jain; Rohit Jain
Journal:  Proc (Bayl Univ Med Cent)       Date:  2022-05-23

10.  "Where do we go from here?" Health system frustrations expressed by patients with multimorbidity, their caregivers and family physicians.

Authors:  Ashlinder Gill; Kerry Kuluski; Liisa Jaakkimainen; Gayathri Naganathan; Ross Upshur; Walter P Wodchis
Journal:  Healthc Policy       Date:  2014-05
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