Toolkit to Increase Provider Knowledge, Comfort, and Adoption of POLST: Portable Medical Orders in a Primary Care Setting.

BACKGROUND: POLST-Portable Medical Orders-abbreviated as POLST, is a nationwide initiative to help providers document and meet a patient's end-of-life wishes. PROBLEM: Provider completion of POLST documents in primary care can promote continuity and implementation of patient preferences at the end of life in community-dwelling adults. Educating and providing a clinical process to support POLST use may improve implementation. APPROACH: A POLST toolkit was developed for primary care providers with measurement of knowledge, comfort, and likelihood of use with pre- and postsurvey data collection. The POLST toolkit was used to engage primary care providers in an educational session to enhance understanding and increased utilization. OUTCOMES: Providers reported increased knowledge, self-reported comfort, and likelihood of using POLST documents. CONCLUSIONS: Utilization of a POLST toolkit, with an educational component, improved provider interest in POLST implementation.

An integrated model of multimorbidity and symptom science.

BACKGROUND: Prevalence and complexity of persons with multiple chronic conditions (MCC), also known as multimorbidity, are shifting clinical practice from a single disease focus to one considering MCC and symptoms. Although symptoms are intricately bound to concepts inherent in MCC science, symptoms are largely ignored in multimorbidity research and literature. PURPOSE: Introduce an Integrated Model of Multimorbidity and Symptom Science. METHODS: Critical integrative review and synthesis process. FINDINGS: The model comprises three primary domains: 1. Contributing/ Risk Factors; 2. Symptom/Disease/Treatment Interactions; and 3. Patient Outcomes. DISCUSSION: The model highlights the multilevel nature of contributing factors and the recursive interactions among multiple etiologies, conditions, symptoms, therapies, and outcomes.

Fostering Academic-Clinical Research Partnerships.

Academic-clinical research partnerships can benefit academic and clinical partners when goals are clearly articulated and mutually determined and include increased research dissemination and lower research costs. This article explores the history of academic-clinical research partnerships and discusses the drivers of collaborative academic-clinical research relationships, resources from academia and clinical sites, and sustainability of collaborative partnerships. Through collaboration, academic-clinical partners can improve clinical outcomes and reduce healthcare costs.

Learning fine-grained and category information in navigable real-world space.

Spatial judgments are affected by both fine-grained and categorical knowledge. We investigated whether, and how, the two forms of knowledge are learned in real-world, navigable space, as well as the time course of learning each type of knowledge. Participants were Northwestern University undergraduates who estimated the locations of buildings and other landmarks on campus. The Northwestern campus is roughly divided into three regions whose borders are not easy to discern, either from a map or by navigation. Nevertheless, students often refer to these regions linguistically and use them when making housing decisions, choosing classes, and so forth. We found that knowledge of both the fine-grained configuration of locations and the regional distinctions increased with time. However, regional influences on judgments occurred later in students' time on campus. Consequently, computed distances across the nonexistent border between north and south campus locations became more biased with time. The results have implications for understanding how spatial representations develop in navigable environments.