Tennessee Valley Healthcare System
1310 24th Ave. S
Nashville, TN 37212-2637
Robert Dittus, MD, MPH
Associate Director for Research:
Eugene Wesley Ely, MD, MPH
Associate Director for Education and Evaluation:
Associate Director for Clinical Programs:
James Powers, MD
Tennessee Valley GRECC Research: Critical illness associated cognitive impairment, disease prevention, Drug utilization
Accomplishments: The Tennessee Valley GRECC was established in 1999. Currently it serves elderly Veterans in Tennessee, Kentucky, and parts of West Virginia. In fiscal year 2009 the Tennessee Valley GRECC constructed the VISN 9 Diabetes Care Improvement Project, the VISN 9 Bacterial Blood Culture project, as well as published 83 peer reviewed papers, provided 11,459 person hours of geriatric education, and expended $12,505,202 in research awards. Its current research interests include: cancer prevention; disease prevention; critical illness-associated cognitive impairment; quality and safety of care; and drug utilization.
Education: Disease Prevention, Pharmacoepidemiology, Quality Improvement/Patient Safety, Ethnogeriatrics. There are six active education projects and all six incorporate aspects of all of the above foci. Four of the projects have particularly strong ethnogeriatrics content and/or experiences. The Tennessee Valley GRECC participated in the development of the Ethnogeriatric Curriculum that can be downloaded from: www.stanford.edu/group/ethnoger/. The conceptual framework for all education programs is derived from the principles and practices of adult learning theory, problem based learning, and interdisciplinary team training. All education projects are developed and implemented by Interdisciplinary Faculty Teams and all GRECC trainees learn primarily by doing and in interdisciplinary team settings. Continuous quality improvement is not only an integral part of the GRECC evaluation process, but also an integral part of all education/training activities.
Clinical: Clinical Focus: Disease Prevention, Therapeutics Several clinical demonstration and best practice projects of the Tennessee Valley GRECC address prevention and medication issues, often jointly, in areas such as delirium in elders on ventilators in the ICU, glycemic control in the aging veteran, medication treatment of depression and failure-to-thrive in older veterans, and obesity management. In addition, a study of secondary prevention on colorectal cancer screening is underway to determine the most cost-effective procedure for early detection of this disease. The linkages between NSAIDs and colon cancer is only one area of pharmacoepidemiology being explored by GRECC core staff. As new research findings are made available, they are implemented at the bedside on the various clinical units that make up the care continuum at the Tennessee Valley Healthcare System. The Associate Directors for Education and for Clinical work closely to develop mechanisms to disseminate these new research findings throughout the VISN.