The newly-minted Utah Geriatric Education Center is ready to enhance health care provider workforce capacity to improve geriatric preventative care across Utah funded by a $2.6 million federal grant and guided by a unique vision.
Ginny Pepper, Ph.D., R.N., FAAN, who led the grant writing effort and will function as the center's executive director, said much of the program will drive a change in focus nursing homes across the state.
Most people think of long-term nursing home care as sick care, but we're trying to shift that perspective to preventative care," said Pepper. "We want to make the nursing home the primary care medical home for these patients.
The medical home model uses a collaborative multi-disciplinary team to catch and address medical issues before they develop into serious concerns that require emergency department visits or hospital admissions.
The Division of Geriatrics has applied this thinking to its new Geriatric Medical Home Clinic for outpatient care. The UGEC initiatives will extend this philosophy to long term care services and supports settings.
The preventative care model is based on teamwork, communication, and skill-building, said Pepper. UGEC's mission in part will be to teach nursing home caregivers how to implement the medical home concept.
The foundation of the UGEC program is an innovative distance learning system that will allow University educators to have real-time, two-way contact with participating staff in 21 partner nursing facilities, many of which are in rural locales that make travel for educators or students impractical.
The UGEC brings community partners and multiple players from University Health Sciences under the same umbrella. Joining the effort are long term care facilities administered by Avalon Health Care and Mission Health Services, along with Health Insight and the Alzheimer's Association.
The exciting aspect of UGEC is that although we have different health care discipline programs involved, common curricular strands are woven through all of them," said UGEC Co-Director for Nursing Programs Linda Edelman, Ph.D., M.Phil., R.N. "This allows for inter-professional team building and communications throughout the curriculum.
Edelman and her team will educate nursing staff and certified nursing assistants working in the skilled nursing facilities. In these types of facilities, the nurses and CNAs perform the vast majority of direct patient care, and so their ability to observe changes in the condition of a patient and report those changes to a physician is crucial to effective preventative care.
"Many of the physician medical directors in these facilities don't have training specifically in geriatrics," said Director of the Division of Geriatrics and UGEC Co-Director for Physician Programs Mark Supiano, M.D. "Most of them come from backgrounds in internal medicine or family medicine, though they may have been working in geriatrics for some time."
Supiano plans to provide additional education for nursing home medical directors, leading to certification from the American Medical Director's Association.
"Improved education for geriatric care providers is a huge need in Utah," Supiano said. "Utah ranks near the bottom nationally in terms of providing long term care services and supports."
In addition to the medical director certification, Supiano's team will be using distance education to provide case-based conferences for medical staff providing long term care.
Yet it can't all be done from afar.
UGEC also plans to institute a nursing residency program that will support novice nurses as they enter the job market in long-term nursing care facilities. This residency will include a nursing mentorship program.
Overlaying all of these efforts is an emphasis on training health professionals, patient families, and other caregivers to deal with the challenges of patients with Alzheimer's and associated dementias. That's where Co-Director for Interdisciplinary and Community Programs Kara Dassel, Ph.D., comes in.
"We will be developing online training modules for direct care workers to complete as well as partnering with the local chapter of the Alzheimer's Association to host five community-based educational workshops across the state for community members," Dassel said.
These dementia-related education efforts will reach beyond the skilled nursing facilities to include training for health professionals and non-professional caregivers involved in care in variety of settings, including home care, assisted living, skilled nursing facilities, and hospice.
According to Pepper, education of family members and caregivers can have a tremendous impact on quality of life for patients with Alzheimer's disease and related dementias. In addition to medical treatments, these patients can benefit greatly from efforts to regulate their daily routines and organize their living spaces to minimize confusion and related risk of injury.
The ultimate goal for UGEC is to use these initiatives to create a new template for long-term care of older adults that can be reproduced throughout the state and beyond.
The University was one of 44 organizations nationwide to receive grants from the U.S. Department of Health and Human Services Geriatrics Workforce Enhancement Program.
"This is a huge project. We're lucky to have a lot smart and energetic people involved," said Pepper.