Geriatric Research Education and Clinical Center (GRECC)

What are the GRECCs?

The Geriatric Research, Education, and Clinical Centers (GRECCs) are VA centers of excellence focused on aging. Congress established the GRECCs in 1975 to improve the health and healthcare of older Veterans. GRECCs are located at 20 VA medical centers across the country, and each is affiliated with a major research university.

GRECCs have three main missions:

• To build new knowledge through research
• To improve healthcare through the development of new clinical programs
• To ensure that VA staff have adequate knowledge of aging-related issues

Each GRECC builds on these concepts to create its own mission.

Pittsburgh GRECC’s background and mission statement

The Pittsburgh GRECC, which is affiliated with the University of Pittsburgh School of Medicine, has been serving older Veterans in Pennsylvania, Delaware, and parts of West Virginia since 1999.

Our mission statement reflects the GRECC program’s three main missions. At VAPHS, we strive to:

• Improve and expand the capability of VA's health care facilities to respond with the most effective and appropriate services possible to the medical, psychological, and social needs of the increasing number of older Veterans
• Advance scientific knowledge related to aging Veterans’ needs (and ways of meeting those needs) by facilitating a higher quality of geriatric care. We accomplish this by:
  • Conducting geriatric and gerontological research
  • Training health personnel to provide health care to older Veterans
  • Developing and evaluating improved models of clinical service for older Veterans

Programs for Veterans

The Pittsburgh GRECC offers comprehensive care to older Veterans. Our services include in-home care (including primary care visits) for homebound Veterans, psychological and psychiatric evaluations, physical therapy, occupational therapy, social work consultations, and more.

Geriatric Evaluation and Management Clinic (GEM)

GEM is an outpatient-based consultation service that provides assessment and care coordination for older Veterans in the community. Any clinician can refer patients to the GEM program.

The GEM team includes representatives from geriatric medicine, nursing, psychology, pharmacy, social work, geriatric psychiatry, and physical and occupational therapy. This interdisciplinary team provides comprehensive assessments to patients:

• Assessments take place at the University Drive campus (Oakland). They can take two half-day sessions (or longer) to complete.
• Once GEM team members have completed a patient’s individual clinical evaluation, they’ll have a follow-up discussion to establish a care plan.
• After the team meeting, the patient, their caregiver(s), and GEM practitioners will meet for a family conference.
• GEM patients are expected to participate in the clinical evaluation, team meeting process, and the family conferences.

Home Based Primary Care (HBPC)

The Home Based Primary Care program (HBPC) provides long-term care for chronically ill patients; this care isn’t limited to a certain number of visits. To be eligible for home care, you must be homebound or need assistance to complete activities outside of your home.

At least two-thirds of HBPC patients receive primary care through home physician visits, and homebound patients have access to a number of multidisciplinary programs, including:

• Occupational therapy
• Physical therapy
• Psychology
• Geriatric psychiatry
• Geriatric medicine
• Pharmacy
• Chaplaincy
• Social work

HBPC’s expanded team has provided enormous benefit to homebound Veterans, and multidisciplinary trainees have benefited from learning about the challenges of providing in-home care.

Pittsburgh GRECC’s areas of focus

Research

Research at the Pittsburgh GRECC addresses the following topics:

• Neuronal cell death in stroke and neurodegenerative diseases
• Hearing, communication disorders, and aphasia rehabilitation in people who have had strokes/aging people
• Geriatric cardiology
• Polypharmacy
• Stroke-related outcome measures
• Avoiding inappropriate prescription of medication/medication errors in long-term care
• Barriers to delivery of care to the elderly
• Pain assessment and treatment in the elderly

Education and clinical work

The Pittsburgh GRECC offers interdisciplinary clinical and educational experiences for the following fellows, residents, interns, and trainees:

• Geriatric medicine fellows
• Geriatric psychiatry fellows
• Internal medicine residents
• Medical students
• Psychology fellows
• Psychology interns
• Pharmacy residents
• Clinical pastoral residents
• Nurse practitioner trainees
• Speech pathology clinical fellows
• Audiology doctoral trainees
• Social work trainees
• Physician assistant trainees
• Occupational therapy trainees

GRECC trainees rotate through several geriatric-specific clinics. The main GRECC clinical training sites are the Geriatric Evaluation and Management Clinic (GEM), Home Based Primary Care (HBPC), the Program for Intensive Residential Aphasia Treatment and Education (PIRATE), the Pain Clinic, and the Neurology Clinic.

The Pittsburgh GRECC offers three ways to learn and teach about the geriatric experience and geriatric research:

• A core lecture series, consisting of an interdisciplinary 16-part teaching conference to teach trainees core geriatrics concepts from multiple perspectives
• Interdisciplinary case conferences, during which trainees present patient cases and receive feedback from other participants. The resulting discussion helps trainees understand how different disciplines contribute to the care of older adults.
• A noon conference series, which features weekly conferences covering recent advances in research, education, and clinical practice.

Program staff and contact information

Contact us to learn more about the Pittsburgh GRECC program.

Telephone:
Fax:
Mail:
Pittsburgh VA Healthcare System
GRECC (00GR-H) Highland Drive
Pittsburgh, PA 15206

Pittsburgh GRECC team

GRECC Director
Steven Graham, MD

Associate Director, Research
Patrick Doyle, PhD

Associate Director, Education & Evaluation
(Vacant)

Associate Director, Clinical
Michelle Rossi, MD

Administrative Officer
Dawn Marie Fuhrer