title: Implementing innovative models of dementia care: The Healthy Aging Brain Center.
abstract: BACKGROUND
  Recent randomized controlled trials have demonstrated the effectiveness of the collaborative dementia care model targeting both the patients suffering from dementia and their informal caregivers.
  
  
  OBJECTIVE
  To implement a sustainable collaborative dementia care program in a public health care system in Indianapolis.
  
  
  METHODS
  We used the framework of Complex Adaptive System and the tool of the Reflective Adaptive Process to translate the results of the dementia care trial into the Healthy Aging Brain Center (HABC).
  
  
  RESULTS
  Within its first year of operation, the HABC delivered 528 visits to serve 208 patients and 176 informal caregivers. The mean age of HABC patients was 73.8 (standard deviation, SD 9.5), 40% were African-Americans, 42% had less than high school education, 14% had normal cognitive status, 39% received a diagnosis of mild cognitive impairment, and 46% were diagnosed with dementia. Within 12 months of the initial HABC visit, 28% of patients had at least one visit to an emergency room (ER) and 14% were hospitalized with a mean length of stay of five days. The rate of a one-week ER revisit was 14% and the 30-day rehospitalization rate was 11%. Only 5% of HABC patients received an order for neuroleptics and only 16% had simultaneous orders for both definite anticholinergic and anti-dementia drugs.
  
  
  CONCLUSIONS
  The tools of 'implementation science' can be utilized to translate a health care delivery model developed in the research laboratory to a practical, operational, health care delivery program.
authors.affiliation: Indiana University Center for Aging Research, Indianapolis, USA. mboustani@regenstrief.org
authors.forename: Malaz A
authors.initials: MA
authors.lastname: Boustani
authors.forename: Greg A
authors.initials: GA
authors.lastname: Sachs
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Alder
authors.forename: Stephanie
authors.initials: S
authors.lastname: Munger
authors.forename: Cathy C
authors.initials: CC
authors.lastname: Schubert
authors.forename: Mary
authors.initials: M
authors.lastname: Guerriero Austrom
authors.forename: Ann M
authors.initials: AM
authors.lastname: Hake
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Unverzagt
authors.forename: Martin
authors.initials: M
authors.lastname: Farlow
authors.forename: Brandy R
authors.initials: BR
authors.lastname: Matthews
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Perkins
authors.forename: Robin A
authors.initials: RA
authors.lastname: Beck
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Callahan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003155:Community Mental Health Centers / Q000458:organization & administration; D003704:Dementia / Q000628:therapy*; D005260:Female; D006801:Humans; D007196:Indiana; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D019982:Organizational Case Studies; D018802:Patient-Centered Care / Q000458:organization & administration / Q000592:standards; D011320:Primary Health Care; D016730:Program Development; D019984:Quality Indicators, Health Care