Journal of General Internal Medicine

, Volume 29, Issue 6, pp 926–931 | Cite as

Road Map to a Patient-Centered Research Agenda at the Intersection of Hospital Medicine and Geriatric Medicine

  • Heidi L. Wald
  • Luci K. Leykum
  • Melissa L. P. Mattison
  • Eduard E. Vasilevskis
  • David O. Meltzer
Perspective
First Online:

ABSTRACT

As the United States ages, the patient population in acute care hospitals is increasingly older and more medically complex. Despite evidence of a high burden of disease, high costs, and often poor outcomes of care, there is limited understanding of the presentation, diagnostic strategies, and management of acute illness in older adults. In this paper, we present a strategy for the development of a research agenda at the intersection of hospital and geriatric medicine. This approach is informed by the Patient-Centered Outcomes Research Institute (PCORI) framework for identification and prioritization of research areas, emphasizing input from patients and caregivers. The framework’s four components are: 1) Topic generation, 2) Gap Analysis in Systematic Review, 3) Value of information (VOI) analysis, and 4) Peer Review. An inclusive process for topic generation requiring the systematic engagement of multiple stakeholders, especially patients, is emphasized. In subsequent steps, researchers and stakeholders prioritize research topics in order to identify areas that optimize patient-centeredness, population impact, impact on clinical decision making, ease of implementation, and durability. Finally, next steps for dissemination of the research agenda and evaluation of the impact of the patient-centered research prioritization process are described.

KEY WORDS

geriatrics hospitals hospitalists patient-centered care research 
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Notes

Acknowledgements

Contributors

Claudia Stahl, Society of Hospital Medicine; Angela Richard, Brian Bandle, and Julie Slater, University of Colorado School of Medicine.

Funders

This work was supported by the American Association of Instructors of Medicine/ Association of Specialty Providers, and the John A. Hartford Foundation. Dr. Wald is supported by a Paul Beeson Career Development Award in Aging (NIA 5 K23 AG034544). Dr. Mattison acknowledges the support of Rx Foundation. This work was also supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (REA 05–129, CDA 07–022). Investigator salary support (to Dr. Leykum) is provided through this funding, and through the South Texas Veterans Health Care System. Dr. Vasilevskis was supported by the National Institute On Aging of the National Institutes of Health (K23AG040157) and the Veterans Affairs Clinical Research Center of Excellence, and the Geriatric Research, Education and Clinical Center (GRECC).

Prior Presentations

None.

Conflict of Interest Summary

Wald: none; Leykum: none; Mattison: UpToDate (contributor), Practical Reviews in Hospital Medicine (contributor/reviewer); Vasilevskis: none; Meltzer: PCORI Methodology Committee (member).

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Copyright information

© Society of General Internal Medicine 2014

Authors and Affiliations

  • Heidi L. Wald
    • 1
  • Luci K. Leykum
    • 2
  • Melissa L. P. Mattison
    • 3
  • Eduard E. Vasilevskis
    • 4
    • 5
  • David O. Meltzer
    • 6
  1. 1.University of Colorado School of MedicineDivision of Health Care Policy and ResearchAuroraUSA
  2. 2.South Texas Veterans Health Care SystemUniversity of Texas Health Science Center at San AntonioSan AntonioUSA
  3. 3.Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonUSA
  4. 4.Division of General Internal Medicine and Public Health, Section of Hospital Medicine and the Center for Quality AgingVanderbilt UniversityNashvilleUSA
  5. 5.Geriatric Research, Education and Clinical Center (GRECC)NashvilleUSA
  6. 6.The University of ChicagoChicagoUSA

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