Models of Care
Partners is the lead agency for many research, consulting and evaluation projects. Through its carefully formulated initiatives, identification of needed resources, project management, application of rigorous scientific design and evaluation, Partners produces nationally recognized new models of care. Some recent examples are:
Palliative Care
Working with Kaiser-Permanente Southern California, Partners has tested and evaluated a new model of end-of-life care that employs a multidisciplinary team approach. This model has demonstrated cost-effectiveness and high levels of patient satisfaction. The highly successful replication in several major sites througout the Kaiser Permanente system moved the health plan to adopt this palliative care model into its member benefits.
The frail elderly who receive care management or home health services are at high risk for medication-related problems. Over the past 10 years, Partners has developed and tested a successful medication-management model to prevent medication errors and improve medication management with funding from The John A. Hartford Foundation. The model has been replicated in three community-based senior care management programs in Los Angeles County with a three-year grant from the U.S. Administration on Aging Evidence-based Prevention Initiative. Based on strong findings from the program, Partners recently received additional funding from the John A. Hartford Foundation to disseminate the model on a national level. (www.homemeds.org)
Healthy Moves for Aging Well Physical Activity Program
Healthy Moves for Aging Well is an evidence-based intervention to bring increased physical activity through in-home exercise to frail, low-income elderly in care-management agencies. Partners developed and conducted a pilot project of the program with funding from the John A. Hartford Foundation and guidance from the National Council on the Aging. After six months of participation, 76.2% of the clients were retained in the program. Partners is currently funded by Archstone Foundation and The California Endowment and sponsored by the U.S. Administration on Aging Evidence-based Prevention Initiative. The purpose of this initiative is to train care managers to teach evidence-based exercises to their homebound, frail elderly clients to improve their functional level of independence and quality of life. (more)
Field Study Funded on Adding Social Workers to Seniors’ Primary Care to Improve Health, Reduce Physician Visits and Hospitalization
After a multistage review process with national experts, IGSW (Institute for Geriatric Social Work) selected Partners in Care Foundation/Kaiser Permanente in Southern California as the site for the Institute's randomized control trial in primary care intervention. Scott Miyake Geron, Ph.D., IGSW's Director, is the Principal Investigator of the study, and Bronwyn Keefe, M.S.W., M.P.H., is the Co-Principal Investigator. The Project Director for the California site is be W. June Simmons, LCSW, who is the President/CEO of Partners in Care Foundation, and the Research Director is be Susan Enguidanos, Ph.D., MPH, also of Partners in Care Insistitute for Change/ Research Center. This project develops and tests an enhanced social work care management intervention with frail older adults in a primary care setting. The intervention is designed to reduce hospitalization and improve patient outcomes. At the core of the intervention will be the use of intensive Problem-Solving Treatment (PST), a validated behavioral change approach shown to be effective in treating depression and other psychosocial problems.
