Addressing the Critical Shortage of Geriatric Health Care Leaders

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Addressing the Critical Shortage of Geriatric
Health Care Leaders
Eric A. Coleman, MD, MPH, AGSF, FACP Professor of
Medicine Executive Director, Practice Change
Fellows Program University of Colorado
Denver www.practicechangefellows.org
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Program Overview

• Build leadership capacity among health care
  professionals with operational responsibility for
  aging programs geriatric service lines
• 8-10 Fellows selected in annual competition
• Nurses, Physicians, Social Workers
• Highly engaged National Advisory Board
• Foster national network and platform for change

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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What is Approach?

• Incorporate leadership development into day job
• Convene in person three times per year
• Expand the mentor-mentee dyadmentoring pods
• Project is a vehicle for leadership development
  augmented by a formal learning contract
• Attend customized national leadership experience

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Six Skill Seminars for System Change

• Compelling outcomes for program sustainability
• Presenting a compelling business case
• Building high performing teams
• Fostering cross setting collaboration
• Leading cultural change
• Negotiating conflict

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Practice Change Fellows Program Logic Model
Resources Inputs
Strategies
Fellows Short-term Outcomes
Impact on Fellows Home Organization
Cumulative Long-term Impact
Fellows Workplan and Contract

• Fellows
• Fellows projects
• Fellows home organizations
• Advisory Board
• Program Office
• Atlantic Philanthropies John A. Hartford
  Foundation
• Program curriculum
• National Leadership Training
• Evidence based models
• Evaluation

Organizational Leaders Responsive

•  

Fellows Awareness Knowledge Skills
Improved Care and Enhanced Value in Health and
Health Care for Older Adults
PCF Leadership Training
Improved Capacity for Serving Older Adults
 Fellows Project
Fellows Project Support
Improved Efficiency in Serving Older Adults
Fellows Longer-term Outcomes
Improved outcomes
External Leadership Course
In the Home Institution
Improved Health Outcomes for Older Adults

• Broader Influence Of Home Organization

Career Advancement
Dissemination by Program Office or by National
Advisory Board Members
Additional Dissemination of Projects
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Diffusion of Innovations

• Diffusion of innovations is a theory of how, why,
  and at what rate new ideas and technology spread
• Central role of leadership to evaluate among
  evidence based approaches and customize to unique
  settings

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Translation of Evidence Based Models (T2/T3)

• Fellows (and Advisory Board) well positioned to
  implement evidence-based models in their home
  organizations and beyond
• Chronic Disease Self-Management Program
• BOOST (Better Outcomes for Older Adults Safe
  Transitions)
• Care Transitions Intervention

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Bridging Practice Change and Health Policy

• Whether through legislative or regulatory
  approaches, delivery system reform cannot be
  successful without the experience and expertise
  of practice leaders.
• Fellows and Advisory Board understand how to
  implement a patient-centered medical home, an
  accountable care organization, a bundled payment
  approach, and strategies to realize the potential
  of health information technology.
• Incorporate activities that serve to amplify the
  programs influence at this critical interface
  between practice and health policy.

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Evaluation Gains in Skills (scale 1-5)

• Business case pre 2.65/post 4.35
• Lead quality improvement pre 3.20/post 4.35
• Engage support of senior leadership pre 3.30/post
  4.50
• Align goals of key stakeholders pre 3.05/post
  4.30
• Describe a specific policy or regulatory barrier
  to practice improvement pre 2.50 /post 3.60

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Evaluation Home Supervisor

• Fellows project has become incorporated90
• Beyond the PCF project, the Fellow has garnered
  financial support from the organization for
  further practice change efforts90
• Fellows project has improved health-related
  outcomes for older adults80
• Fellows change efforts are having a positive
  impact beyond our organization80

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Evaluation Alumni

• Project implemented100
• Project demonstrated improvement in outcomes for
  older adults100
• Project saved home organization (40)

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Evaluation Meeting Attendance

• Advisory Board rate of attendance 93
• Gain cutting edge content
• Foster next generation
• Interact with one another
• Be part of something larger

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Financial Leverage

• Match from Fellows home institution (1.7M)
• Fellows leverage (2.3M)

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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Illustrative Examples

• Dan Reece, MSW (PeaceHealth)
• Ilaina Edison, RN, MBA (Visiting Nurses Services)
• Eran Metzger, MD (Hebrew Senior Life)

Supported by Atlantic Philanthropies John A.
Hartford Foundation
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To Learn More Please Visit

• www.practicechangefellows.org

Supported by Atlantic Philanthropies John A.
Hartford Foundation