Transforming clinical training environments to integrated geriatrics and primary care delivery systems to ensure trainees are well prepared to practice in and lead these kinds of systems.
Physician Center at Mililani: Monthly integrated geriatrics and primary care Annual Wellness Visit clinics run by interprofessional teams. Students from the schools of nursing, pharmacy, social work and medicine collaborate in the care of patients together.
Kokua Kalihi Valley (KKV) Comprehensive Family Sevices (an FQHC): Uses weekly exercise groups as the opportunity to screen elders at risk in their healthcare system. Geriatric screening events are coupled with educational topics for seniors taught by nursing students.
Hawaii Primary Care Association (HPCA): We are working with HPCA (which serves all FQHCs in Hawaii) to identify other primary care training sites to spread this model during Year Three.
Developing providers who can assess and address the needs of older adults and their families/caregivers at the individual, community, and population levels.
Provider Training: Since July 2016, we have trained 506 providers from a variety of disciplines through a variety of conferences seminars and grand rounds. We also trained 130 medical students, residents and fellows from JABSOM. Since August 2016, we collaborated with AHEC to provide a monthly CME activity via Project ECHO videoconference transmissions that reach neighbor islands and rural areas of the state.
Allied Health Schools: We have been collaborating with the faculty at the Schools of Nursing, Pharmacy, Social Work, Medicine and Public Health in creating and refining the lnterprofessional Educational (IPE) training curricula at the School of Nursing Simulation Center. Together, we developed the Hawaii lnterprofessional Team Care Simulation (HIPTCS), where students from all 5 disciplines work together on a case (with the role of the patient’s daughter played by student actors from the theater department) involving interprofessional discharge planning for a geriatric patient admitted to the hospital with falls and polypharmacy.
Development of a Community Health Worker (CHW) and Licensed Practical Nurse (LPN) pipeline: We are addressing the workforce shortage by collaborating with Kapiolani Community College (KCC) in creating a 2-year Community Health Worker. It is now being taught at UH Maui College. Plans are to start the CHW program in Spring 2017 on Oahu at Papakolea and Waianae Coast Comprehensive Health Center (WCCHC), and at Kauai Community College. The KCC LPN pipeline has enhanced its curriculum to include more geriatric content.
Creating and delivering community-based programs that will provide patients, families and caregivers with the knowledge and skills to improve health outcomes and the quality of care for the older adult.
Video Series: Our goal is to create a Hawaii Caregiver Training and Empowerment Video Series, including local trigger videos, on the following topics: Normal aging dementia; Caregiver burnout; Quality of life for all stages of Dementia and provide Alzheimer’s Association print materials; and Provide “how to” videos for caregivers. The first video on dysphagia will be ready in Spring 2017.
Family/Caregiver Training: We provide direct teaching to patients1 families and caregivers through a variety of venues, including the 6-week “Mini-Medical School” for the lay public training for caregivers at HMSA, monthly seminars at One Kalakaua Assisted Living Facility, and training opportunities through our partners at AARP and Alzheimer’s Association.
Pacific Islands: We continue to provide support for the Family Caregiver Certificate Training (Palau Community College, American Samoa). We’ve worked with MPQH on their Diabetes Curriculum, enhancing geriatric and dementia content which is taken to Guam and American Samoa.
Cultural Sensitivity: All dementia and caregiver resources/training materials are developed to be culturally sensitive, particularly for Native Hawaiian and Pacific Islander populations.