The VA Geriatric Scholars Program

One of the GRECC missions is to export successful educational models. The GSP was adopted by the non-VA Western New York Medical Foundation and may be adapted as a VA Palliative Care Scholars Program. The VA Eastern Regional Rural Health Center has also explored implementing the model for training. The value of the program has also been recognized recently with 2 national awards. In 2012, the QI curriculum was recognized with the Duncan Neuhauser Award for Curricular Innovation in Healthcare Improvement by the Academy for Healthcare Improvement. More recently, Josea Kramer, PhD, program director, received the David M. Worthen Award for Educational Excellence from the VA Office of Academic Affiliations, in part based on the impact of the GSP enhancing geriatric skills and competencies in the VA primary care workforce.

Geriatric Scholars’ clinical teams in small rural CBOCs have made a difference with a focused local issue that could serve as a model for wide application throughout VHA. The projects have included improving access to oral and dental health to all clinic users; prioritization for community-based, long-term care options; identification and support for caregivers; documentation of end of life preferences; and follow-up after non-VA hospital discharges; other projects have reduced polypharmacy, falls, and clinic no-shows.

The impact of the GSP has been substantial, and learners represent every VISN. To date, the GSP has trained 1,901 VA clinicians at more than 360 facilities. The majority had no previous training in geriatrics, even during medical residency or associated health profession internships, yet today, older adults comprise an average 72% of their current patient panels.

Scholar Feedback

In testimonials, geriatric scholars have given positive feedback for many aspects of the program. Attending the program was “one of the best decisions of my life educationally and personally and opened my eyes to what is out there in geriatric care,” one scholar insisted. “This program has helped me with my day-to-day practices,” another attendee noted, “I feel more comfortable in my role. I can communicate better with my team and patients.”

Related: Using Facilitative Coaching to Support Patient Aligned Care Teams

One of the outcomes of the program was to standardize care for older veterans by teaching the state-of-the-art in geriatrics to clinicians who would teach-back the principles across disciplines and in their respective primary care settings. “I am using the [standardized brief cognitive instrument for] memory testing...that I have learned....The doctors really like it!” explained one attendee. “I went through the [GSP Learning Community] SharePoint site and picked out [a standardized brief cognitive instrument] CPRS template after our [RITT] training. I have already shared with our service line and got it approved,” added another scholar. The SharePoint site is open all VA employees.

Another outcome of the opportunity to teach-back has been preparing the interdisciplinary clinical team to interact efficiently within the environment of the patient-centered medical home or PACT. “The Geriatric Scholars Program showed how we should put veterans at the center, involve the entire team (nurses, pharmacy, etc.) in their care,” a scholar explained. “The Geriatric Scholars Program is a great tool to help roll out [PACT] at my CBOC,” another scholar reported. “I used the mentoring I got from the Geriatric Scholars Program to teach my clinic team.”