Susan E. Hickman

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https://hdl.handle.net/1805/7275

Professor Susan Hickman (Professor, School of Nursing, Community & Health Systems) is committed to optimizing the quality of life for older adults in life’s final chapter through informed, values-based decision-making and effective communication about their treatment preferences. A primary focus of her research is the Physician Orders for Life-Sustaining Treatment (POLST) program, which improves the continuity of care by communicating patients’ treatment preferences as actionable medical orders. Findings from her research have been widely disseminated and are used across the country to support programs based on the POLST model.

Hickman co-founded the Indiana Patient Preferences Coalition, a group of individuals and organizational representatives from law, medicine, nursing, senior care, and ethics. The coalition created the Indiana POST (Physician Orders for Scope of Treatment), which is based on the national POLST model. Dr. Hickman provides education and facilitation skills-training for POST to health care providers around the state. The National Institutes of Health recently awarded her a second grant to study the quality of POLST decisions. She also serves as the Palliative Care Core lead on a Centers for Medicare and Medicaid Services innovations grant where POLST is used to reduce avoidable hospitalizations and improve care in 19 Indianapolis area nursing facilities. Her collaboration with colleagues at IU Health resulted in the launch of the Encompass Initiative, which will provide education to improve primary palliative care throughout the academic health system.

Professor Hickman’s work to improve the quality of life for older adults in life’s final chapter is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.

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Browsing Susan E. Hickman by Author "Balio, Casey P."

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    Facility and resident characteristics associated with variation in nursing home transfers: evidence from the OPTIMISTIC demonstration project
    (BMC, 2021-05-24) Blackburn, Justin; Balio, Casey P.; Carnahan, Jennifer L.; Fowler, Nicole R.; Hickman, Susan E.; Sachs, Greg A.; Tu, Wanzhu; Unroe, Kathleen T.; Health Policy and Management, School of Public Health
    Background: Centers for Medicare and Medicaid Services (CMS) funded demonstration project to evaluate financial incentives for nursing facilities providing care for 6 clinical conditions to reduce potentially avoidable hospitalizations (PAHs). The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) site tested payment incentives alone and in combination with the successful nurse-led OPTIMISTIC clinical model. Our objective was to identify facility and resident characteristics associated with transfers, including financial incentives with or without the clinical model. Methods: This was a longitudinal analysis from April 2017 to June 2018 of transfers among nursing home residents in 40 nursing facilities, 17 had the full clinical + payment model (1726 residents) and 23 had payment only model (2142 residents). Using CMS claims data, the Minimum Data Set, and Nursing Home Compare, multilevel logit models estimated the likelihood of all-cause transfers and PAHs (based on CMS claims data and ICD-codes) associated with facility and resident characteristics. Results: The clinical + payment model was associated with 4.1 percentage points (pps) lower risk of all-cause transfers (95% confidence interval [CI] - 6.2 to - 2.1). Characteristics associated with lower PAH risk included residents aged 95+ years (- 2.4 pps; 95% CI - 3.8 to - 1.1), Medicare-Medicaid dual-eligibility (- 2.5 pps; 95% CI - 3.3 to - 1.7), advanced and moderate cognitive impairment (- 3.3 pps; 95% CI - 4.4 to - 2.1; - 1.2 pps; 95% CI - 2.2 to - 0.2). Changes in Health, End-stage disease and Symptoms and Signs (CHESS) score above most stable (CHESS score 4) increased the risk of PAH by 7.3 pps (95% CI 1.5 to 13.1). Conclusions: Multiple resident and facility characteristics are associated with transfers. Facilities with the clinical + payment model demonstrated lower risk of all-cause transfers compared to those with payment only, but not for PAHs.