PHILADELPHIA — Rebecca L. Trotta, PhD, RN, director of nursing research and science at the Hospital of the University of Pennsylvania, was awarded a three-year, $1.5 million grant from the Health Resources and Services Administration (HRSA) to develop a nurse-led care model for geriatric patients at the Hospital of the University of Pennsylvania (HUP). The grant will support education in both geriatrics and interprofessional collaborative practice for nurses, physicians, pharmacists, therapists, social workers, and nutritionists on three medical inpatient units at HUP. Nurses on these units will complete the Nurses Improving Care for Health System Elders (NICHE) geriatric resource nurse (GRN) curriculum and undergo additional training in comprehensive geriatric assessment to become GRNs. This training provides the foundation for GRNs to deliver individualized care to older adult patients and lead the interprofessional team in providing well-coordinated, geriatric-focused care.
The project addresses a critical need, both locally and nationally. Philadelphia’s population ranks fifth oldest among U.S. major cities, and Pennsylvania is home to the second oldest population among the 50 states. By the year 2030, the number of U.S. adults over age 65 will grow from 37 million to over 70 million, accounting for an increase from 12 to 20 percent of the United States population. Older adults are high utilizers of health care services, representing 35 percent of all hospital admissions. In addition, their health and social needs are complex. Hospitalized older adults are at increased risk for negative outcomes such as deteriorating cognition, loss of function, falls, malnutrition, increased length of stay, and readmission. Further, family caregivers of older adults are at risk for increased caregiver stress and burden, and are often ill-equipped to manage the care of their loved ones post-discharge.
“The clinical care model incorporates medicine, pharmacy, social work, therapy, and other disciplines to provide an answer to the gap in geriatric care,” said Trotta, who is also coordinator of HUP’s Nurses NICHE program. “This grant grows nurses’ capacity to lead that team in providing comprehensive, individualized, geriatric-focused care.”
The grant will also support activities beyond direct clinical care. Teams on three medical inpatient units will implement quality and safety initiatives focused on the geriatric population and hold interprofessional case conferences. These case conferences will provide an opportunity for teams to receive ongoing coaching from senior geriatricians to strengthen their geriatric skills and collaborative practice.
“We are delighted that HUP nurse researchers are driving this holistic approach to support the needs of this growing population,” said Victoria Rich, PhD, RN, FAAN, chief nurse executive for the University of Pennsylvania Medical Center. “With this collaborative team skilled in geriatrics, we can help ensure more safe, efficient, effective, and equitable care for these patients and their families within acute care settings.”
As the project unfolds, nurses will work with the HUP Patient and Family Advisory Council to strengthen patient and family partnerships and engagement in geriatric care, both in the hospital and during care transitions. The GRN-led interprofessional model will incorporate specific patient and family-centered activities such as ensuring participation in care planning, targeted assessments of caregiver preparedness, and individualized support during transitions in care.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2013 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2013, Penn Medicine provided $814 million to benefit our community.
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