Orientation Manual for Geriatric Assessment Clinic
TABLE of CONTENTS:
1)
2)
3)
4)
5)
6)
7)
Overview of Geriatric Clinic
Progress notes
Geriatric consult completion
Encounter completion
Geriatric exams
Pharmacy consults
Miscellaneous consults
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1) Overview of Geriatric Clinic:
 Geriatric clinic is comprised of a multi-disciplinary team that includes geriatricians, a
geriatric psychiatrist, a clinical pharmacist, and a social worker. Clinic days will begin
with a pre-clinic lecture, starting at 8am, followed by patient visits. Residents will see
the patients and then proceed to check out with the attending physicians. The geriatric
psychiatrist, social worker, and pharmacist will also be available for consultation, if
needed.
2) Progress Note:
 Go to the notes section in CPRS -> select template -> select shared template -> select
geriatrics -> select new appt (for brand new patients) or clinic progress note (for return
patients) -> type in geriatric and select geriatric assessment clinic MD note -> select the
attending physician that will be checking out the patient and “patient seen/examined by
attending physician and discussed plan of care with resident.”
 Once you sign your notes, you can add additional co-signers. Right-click and select
identify additional signers, type in the provider's name.
 See screen captures on the following page (important sections highlighted in red boxes)
Screen Capture of Templates/Progress Notes:
3) Geriatric consult completion:
 Complete consults for new geriatric patients
 Go to consults -> find the geriatric consult -> go to the menu bar and selection Action ->
select consult results -> complete/update results -> geriatric consult -> type the
following : “Please see the geriatric clinic noted date XX/XX/XXXX.”
4) Encounter completion
 New patients
 Go to the notes tab -> select encounter -> select consultation -> select the
estimated time you spent with the patient -> determine if the visit is for a
service connected illness and check accordingly -> go to diagnosis and select at
least 2 diagnoses that were addressed during the clinic visit.
***** Go to procedures: click on assessment -> click S0250 code box for
"comprehensive geriatric assessment team" ******
 Return patients
Go to the notes tab -> select encounter -> select established patient-> select
the estimated time you spent with the patient -> determine if the visit is for a
service connected illness and check accordingly -> go to diagnosis and select at
least 2 diagnoses that were addressed during the clinic visit.
5) Geriatric exams:
 Please familiarize yourself with these tests prior to your first day in clinic.
 SLUMS exams -> this test is an alternative to the MMSE:
slumsexam.pdf

Geriatric depression scale:
geriatric depression
scale.pdf
6) Pharmacy consults:
 Consults are required for the dementia medications used at the VA.

See attachment for information on dementia medications:
Treatment of
Alzhiemer’s Disease.ppt


Galantamine:
 Go to consults -> pharmacy galantamine consult -> fill out the consult and place
the order (see attachment above for dosing recommendations).
 The following labs and test are required for galantamine approval:
 TFTs, RPR, B-12, folate, brain imaging
 SLUMS score or MMSE score needed for approval:
 SLUMS score - < 23
 MMSE score - < 26
Memantine
 Go to consults -> pharmacy outpatient NF -> fill out consult and place order
(see attachment above for dosing recommendations).
 SLUMS score or MMSE score needed for approval:
 SLUMS score - < 13
 MMSE score - < 14
7) Miscellaneous consults
 GRECC continence clinic (pts with continence issues)
Go to consults -> select GRECC continence clinic
 Falls clinic (pt with reports of falling)
Go to consults -> select occupational therapy -> select continue -> select fall
prevention clinic
 Prosthetic s (pts in need of mobility devices)
Go to consults -> select prosthetics clinical pathway -> mobility -> select the
device needed
 See below for the screen capture of consults