Geriatric Research Education and Clinical Center (GRECC)
Eastern Colorado GRECC Clinical Overview
Eastern Colorado GRECC is a hub of clinical innovation committed to creating systems of support for Veterans as they age and across the continuum of care, regardless of geography. The Eastern Colorado GRECC participates in national clinical dissemination projects, including GRECC Connect and Gerofit.
Clinical demonstration projects provide opportunities to integrate research, education and clinical services. Current Clinical Demonstration Projects include:
The goal of GRECC Connect is to improve access to geriatric care for Veterans in rural areas. Older Veterans living in rural areas often have limited access to geriatric care and rural providers and staff often lack opportunities to learn about best practices for management of Veterans with geriatrics syndromes.
The Eastern Colorado GRECC links geriatrics specialists (geriatricians, palliative care physicians, geropsychologist, social workers, pharmacists, audiologists and trainees), located at Rocky Mountain Regional VAMC with six outlying community-based outreach clinics (CBOCs) and Veterans in their homes.
- Activities: Current modalities include clinical video telehealth, electronic consultation, and educational teleconferences. Consultation is provided in tele-geriatrics, tele-palliative care, and tele-geropsychology. All visits are transdisciplinary with at least physician, social worker, and pharmacist input. Many veterans and caregivers are also seen by the geropsychologist, especially related to dementia and caregiver support needs.
Through this project, we aim to equip rural providers and staff with the knowledge and skills to care for older adults, and to support staff at rural clinics by providing geriatrics consultation.
- Accomplishments: In FY18, the GRECC Connect program served 154 veterans and resulted in 30,412 miles saved by providing tele-health visits closer to the veterans’ residence.
Targeted Audiologic Training and Support
Audiology Clinical Demonstration Project trains Associated Health Trainees, Geriatric Medicine Fellows and GRECC clinical faculty on audiology best practices while supporting patient referral for hearing health screening. Tinnitus and hearing loss are the two most prevalent disabilities reported among Veterans receiving VA benefits. Hearing loss causes, contributes to, or exacerbates: communication challenges, social isolation, anger, frustration, fatigue and cognitive decline.
The director of the audiology department at the Rocky Mountain Regional VA Medical Facility and two successive cohorts of GRECC-supported audiology externs have carried out a clinical demonstration project that focuses on providing training in audiology best practices to other Associated Health trainees, Geriatric Medicine Fellows and GRECC clinical faculty.
Our needs assessment identified that health care providers receive little to no education in audiology best practices, despite the high percentage of older Veterans with significant hearing loss. The audiology supervisor and trainees address this gap through a variety of approaches described in detailed in the clinical demonstration project section of this report.
VA Tele-health (CVT) (geriatrics, dementia, palliative care)
Geriatric Evaluation and Management (inpatient and outpatient clinic)
Patient-aligned care teams (PACT) in geriatrics and palliative care
Contract Nursing Home Program: this program pays for housing of Veterans in local nursing homes
Advance Care Planning Group Medical Visits Program using The Conversation Project tool