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Geriatric Research Education and Clinical Center (GRECC)

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GRECC Featured News Highlights

Every quarter the GRECC's submit newsletters on research, education, and clinical innovations.
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GRECC Education Programs Offer Value to Veterans, Trainees, and Providers

These are a small sampling of initiatives from among the many Clinical Activities currently underway in VHA’s Geriatrics Research, Education, and Clinical Centers (GRECCs).

Gainesville GRECC: Think Delirium

Think Delirium is a program that began as a non-institutional long-term care nurse-driven project to early identify and treat hospitalized patients at risk for delirium. An interdisciplinary Delirium Consult Team consisting of nursing, psychiatry, geriatrics, and pharmacy was developed and is currently active at Gainesville and Lake City, Florida VA Medical Centers. In addition, an electronic Delirium Response Order set is fully operational in both locations thanks to the Veterans Integrated Service Network (VISN) 8 which funded the project. To date, over 898 consults were completed with an average of five new consults per day. Among Veterans in whom a consult was completed, 50% were discharged back to home and the 30-day re-admission rate was 22%. Most of the consult recommendations involved reducing polypharmacy and potential drug-drug interactions, using non-pharmacological approaches to delirium and addressing behavioral issues.

For more information, contact Rebecca Beyth at 352-548-6000 ext 6895.

Minneapolis GRECC: Improving the Diagnosis and Management of Neurocognitive Disorders (NCD) in Patient Aligned Care Teams (PACT)

Improving the Diagnosis and Management of Neurocognitive Disorders (NCD) in Patient Aligned Care Teams (PACT) was initiated in 2014. The University of Minneapolis School of Nursing agreed to address this initiative as a QI project for students in their Doctor of Nursing Practice (DNP). In 2017, the SKY PACT, a pilot clinic for this new model, began collecting outcome data. They collected data on 39 specific parameters for Veterans with suspected cognitive impairment. In 2018, the student DNPs worked with the biostatistician and GRECC staff to refine process and outcome variables. Their focus is on:

  • The updated 2016 Dementia Management Quality Measures with special attention to Advance Care Planning and palliative care counseling
  • Education and support of caregivers
  • Screening and management of behavioral symptoms

For more information, contact Riley McCarten at 612-467-3314.

Palo Alto GRECC: E-Consults and Dementia

E-Consults and Dementia is a new collaborative project, initiated in 2017, between the GRECC and the Palo Alto Health Care System Medical Service. Comprehensive E-consults involving chart review and phone evaluation are utilized to provide management of disruptive behaviors in Veterans with dementia who are physically or geographically otherwise unable to assess such expertise by other modalities. Providing the consult requires that the consulting geriatrician review the electronic chart and make telephone calls to family caregivers, or to both family and caregiving staff, to ascertain details about the Veteran’s behaviors, triggers for the behaviors, management attempts, and other information. Developed plans include both behavioral and environmental management techniques and, if necessary, prescribing of medications. All medications are prescribed and reviewed by the consulting geriatrician.

For more information, contact Joyce Tenover at 650-849-0580.

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