Duke GEC Performance Narrative – Duke Geriatric Education Center
UB4HP19203
2/12/2016
PERFORMANCE NARRATIVE – Updated January, 2012
Brief Description of the GEC
The Duke Geriatrics Education Center (GEC) is designed to develop and deliver interprofessional education in geriatrics
by creating a centralized resource (the Hub) for interprofessional faculty development, undergraduate and postgraduate
interprofessional teaching and training in geriatrics and coordination of quality improvement efforts for care of older
adults.
Implementation of evidence-based approaches, for the care of older adults at risk for delirium. was selected from
six topics mandated by the funder as the clinical focus of the Duke GEC.
The specific objectives are:
(1) establish the Duke Interprofessional Geriatrics Education Resource Hub to coordinate the delivery of
proposed programs, ensure availability of needed tools, training and expertise to support these initiatives, and
monitor for achievement of objectives;
(2) develop an interprofessional group of academic and community-based faculty educators who teach in
geriatric medicine, nursing, physician assistants, physical therapy, and pharmacy programs at the university level,
with specific expertise in teaching geriatrics, team care and quality improvement;
(3) engage learners from different professions enrolled in both curricular and continuing education
programs to participate in coordinated didactic and clinical teaching from interprofessional faculty in the
care of the older adults in and between different settings;
(4) design and execute a series of quality improvement initiatives in collaboration with sites where students
rotate, facilitated by the interprofessional faculty team and selected learners to enhance care delivery and
improve outcomes of care in and between different settings.
Organizational Structure
Faculty, leadership and administrative staff are organized into four overlapping teams, with responsibilities outlined
below. Each team has interprofessional co-leaders appointed, and meets at least twice each month. One meeting each
month is with the GEC faculty as a whole to promote cross-team communications. Teams also post materials online in a
faculty workspace contained in our Moodle Learning Management System [http://interprofessionalgeriatrics.duke.edu].
Leadership Team: provides overall direction for Center, and conducts evaluation of Center process and outcomes.
Membership: Heflin, McConnell, Burgess, Egerton, Konrad, Mitchell and Pinheiro, and co-leads of each faculty team.
Team 1: Foundations of Interprofessional Delirium Prevention and Care, identifies and creates instructional resources
and activities for teaching of diverse professions about delirium prevention and care of the delirious patient. The team also
oversees the collection and organization of materials online and devises strategies for their implementation and
evaluation.
Team 2: Clinical Applications of Interprofessional Delirium Prevention and Care, designs and tests clinical experiences
for learners from different professions aimed at enhancing learner competency in the recognition and management of
delirium and, in particular, the promotion of cooperative/collaborative care across professions. The group will identify
objectives, recruit clinical sites, collect/disseminate teaching tools and design structured learner assessments.
Team 3: Practice Improvement in Interprofessional Delirium Care, aims to improve patient care processes and
outcomes through facilitation of quality improvement projects. They leverage existing projects, collaborations and
resources to design, implement and test innovations in the prevention of delirium or in care of the delirious patient.
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Duke GEC Performance Narrative – Duke Geriatric Education Center
UB4HP19203
2/12/2016
Selected Accomplishments
 Convened an interprofessional faculty retreat in conjunction with Duke Medicine Grand Rounds and completed
faculty needs assessment regarding interprofessional teaching of delirium
 Endorsed a subset of the Partnership for Healthy Aging (PHA) competencies as a key target for teaching and
learning, and agreed to emphasize communication among the professions, between settings and with patients and
families
 Developed and implemented a monthly faculty development series on interprofessional teaching of delirium and
evaluation of teaching
 Developed and deployed a set of comprehensive curricular resources for learning about the care of the patient
with or at risk for delirium.
o Resources identified or developed include case studies, clinical tools, review papers, lectures, student
assessments, and two online modules on delirium recognition and prevention
o Clinical sites have included the Geriatrics Consultation Service at Duke University Hospital, the Duke
Hospital Emergency Department, Long Term Care facilities in the Triangle region and at the VA
Medical Center.
o Learners have included pre-licensure RN students at NCCU and at Duke University School of Nursing,
internal medicine residents, geriatric medicine fellows, medical students, doctor of physical therapy
students, at Duke, social work students from UNC-CH, speech pathologists, and advanced practice
nursing students from Duke and UNC-Wilmington. Both profession-specific and interprofessional
learning events have occurred.
 Participated in the development of two interprofessional practice improvement projects in Duke Hospital in the
Emergency Department and in the Medical Intensive Care Unit.
 Developed infrastructure for evaluating progress in our teaching and learning focused on interprofessional care for
older adults at risk for delirium or those who have delirium, and
 Collaborated with other GECs nationally to design a national-level evaluation of impact of learning on provider
practice patterns.
Future plans
 Coordinate the placement of learners in an expanded network of clinical locations to include ambulatory
clinics, acute care, long term care, homecare and community-based sites by:
o recruiting new sites for learners, which might include community-based homecare programs, PACE
programs, and long-term-care facilities.
o supporting and evaluating clinical sites through development of a site support network to respond to
the unique needs of individual locations and providers, and,
o providing continuing education to these clinical partners as needed to support curricular and site
development objectives.
 Collaborate with local health care institutions and quality improvement organizations to obtain outcomes data
for analysis for quality improvement projects by:
o Continuing to work with healthcare institutions, including Duke University Health System, and
community partners such as North Carolina Central University, Campbell University School of
Pharmacy
o Broadening our reach to Durham VA Medical Center, and the Carolinas Center for Medical
Excellence to identify project opportunities and data sources.
o Launch additional projects in community and long-term care settings
 Update website to provide a more inviting, engaging, and functional space for asynchronous collaboration and
learning.
 Implement evaluation plan
 Develop an annual meeting to feature presentation of completed projects by learners and clinical partners
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Duke GEC Performance Narrative – Duke Geriatric Education Center
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Barriers
The biggest barrier to our work continues to be managing the diverse schedules and locations of our interprofessional
faculty and clinical partners. We are overcoming these barriers by increasing our faculty and staff capacity to use
educational technology that facilitates collaboration among people in diverse settings. Examples of such technologies
include the Moodle learning management system, Adobe Connect web-conferencing software, and videoconferencing
software.
Linkages
The Duke GEC has strengthened ongoing relationships with its partner educational institutions and community partners,
including the Triangle J Area Agency on Aging, North Carolina Central University, Campbell University, the UNC-CH
Institute on Aging, Croasdaile Village (a local CCRC) and Schools and Centers within Duke such as the Duke Center for
Excellence in Geriatric Nursing Education, and the HRSA-sponsored Evidence-Based Nursing Practice in Geriatric Care
Settings, where faculty in community college settings are sharing resources for teaching of delirium to associate degree
nursing students and staff nurses in rural North Carolina.
Leadership
Mitchell T. Heflin, MD, MHS is the Project Director/Principal Investigator for the GEC project. He oversees
administration of the program, including general curriculum development, program evaluation, budget and personnel
management, relationships and communications with leaders at the various internal and external locations, production of
progress reports and presentations to the Bureau of Health Professions.
Eleanor S. McConnell, RN, PhD, Co-Investigator, works with Dr. Heflin on overall program design and administration.
More specifically, she will work on fostering relationships with external institutions, such as the Area Health Education
Centers, the VA, and other community partners.
Sandro O. Pinheiro, PhD, the Education Director of the GEC project, leads faculty development for the interprofessional
teaching team, providing guidance on methods of evaluation and teaching about cultural competence in education. He
will also oversee the overall evaluation of the GEC.
Interprofessional Faculty
Donald E. Bailey, RN, PhD is a key faculty member of the Interprofessional teaching team, specializing in
Gerontological Nursing education.
Gwendolen T. Buhr, MD has focused on expanding her work on teaching about transitions of care between long term
care and various settings and interprofessional training in quality improvement.
Emily Egerton, PhD provides expertise in educational methods and evaluation, learning systems and distance-learning.
Robert Konrad, PhD focuses on finalizing the design and implementation plan for the evaluation, with a particular
emphasis on identifying impact of teaching on health disparities. He is also available to faculty trainees regarding
publication of results from their individual curriculum development and evaluation activities.
Loretta Matters, MSN leads a carryover project from the previous GEC developing teaching modules and online
simulation. Her leadership and expertise in health systems operations has been critical to our success in partnering with
clinical agencies.
Jason Moss, PharmD focuses on issues relating to pharmacy and interprofessional team teaching. He also acts as a
liaison with Campbell University, recruiting students to enroll in the rotation and communicating our results back to the
school’s leadership.
Cornelia Poer, MSW is involved with teaching teams about geriatric assessment and community resources. She will also
work with other team members on the design and implementation of the patient/caregiver education program.
Julie Pruitt, MS, RD, LDN teaches interprofessional team members regarding effective communication as well as
helping to develop our online presence.
Kathy M. Shipp, PT, MHS, PhD specializes in physical therapy education and coordinates the creation of PT specific
resources for Interprofessional care.
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Duke GEC Performance Narrative – Duke Geriatric Education Center
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2/12/2016
Lisa Shock, PA assists in curriculum design and the recruitment of PA students to participate. She will also help with
design and completion of quality improvement projects emphasizing in long-term care.
Heidi K. White, MD is a key faculty member of the Interprofessional teaching team, specializing in education in Long
Term Care.
S. Nicole Hastings, MD, a health services researcher specializing in care of older adults in the emergency department and
in transitions and Katja Elbert-Avila, MD, a clinician-educator who specializes in long term care and palliative care are
available to the team for consultation on practice improvement projects.
Two faculty members from neighboring North Carolina Central University (NCCU), Jennie DeGagne, PhD, RN, CNE
and Sujaya Devarayasamudram, MSN participate in the interprofessional faculty teams and recruit students from
NCCU to participate in clinical training programs. They both serve as liaisons to community providers and locations in
Durham which may serve as clinical training sites and quality improvement partners.
Joan Pellettier, Executive Director of the Triangle Area Agency on Aging chairs our advisory committee, provides
advice and feedback on program design and, in particular, targets for community engagement and quality improvement.
Administration
Michele Burgess, the GEC project Program Coordinator, provides strategic oversight and coordination of educational
team meetings and learner activities. In addition, she assists in planning and management of program evaluation, data
analysis, and submission of resulting reports and manuscripts.
Michelle Mitchell, the GEC project Operations Coordinator, provides assistance to the program leadership along with the
Program Coordinator, particularly in the utilization of the educational technologies: Moodle learning management system,
Adobe Connect web-conferencing software, and other technologies identified by team members and the learners.
Several members of the team are not paid under the grant, but provide critical support or expertise. Barbara Kamholz,
MD is a geropsychiatrist at the Durham VAMC who specializes in the care of patients with delirium. Yvette West,
MSN, CNS heads the NICHE (Nurses Improving Care of Hospitalized Elderly) program at Duke University Hospital,
which has prepared over 100 Geriatric Resource Nurses is a key ally. Mamata Yanamadala, MBBS is a junior faculty
member in Geriatrics and specialist in clinical teaching methods and quality improvement.
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