Interprofessional training: Geriatrics and palliative care principles for primary care teams in an ACO

ABSTRACT

There is a well-described need to increase the competence of the primary care workforce in the principles of geriatrics and palliative care, and as value-based payment models proliferate, there is increased incentive for the acquisition of these skills. Through a Geriatric Workforce Enhancement Program grant, we developed an adaptable curriculum around commonly encountered topics in palliative care and geriatrics that can be delivered to multidisciplinary clinicians in primary care settings. All participants in this training were part of an Accountable Care Organization (ACO) and were motivated to improve to care for complex older adults. A needs assessment was performed on each practice or group of learners and the curriculum was adapted accordingly. With the use of patient education and screening tools with strong validity evidence, the participants were trained in the principals of geriatrics and palliative care with a focus on advance care planning and assessing for frailty and functional decline. Comparison of pre- and post-test scores demonstrated increased confidence and knowledge in goals of care and basic geriatric assessment. Participants described feeling more able to address needs, have conversations around goals of care, and more able to recognize patients who would benefit from collaboration with geriatrics and palliative care.

KEYWORDS:

• Interprofessional education
• ACOs
• geriatrics
• palliative care

Acknowledgments

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Health Resources and Services Administration or the U.S. Department of Health and Human Services.

Thanks to Dr. James Fanale^1,2,3,4 and Dr. Phillip Clark^5,6, for their Critical Review of the Manuscript. Thanks to Dr. Laugue Sokol-Hessner^7,8,9,10 for help in the co-development of the goals of care table top case featured in Supplementary Appendix S1.

Sponsor’s role: The project was supported by HRSA grant as noted, this allowed the faculty teaching time, but HRSA did not have any direct role in the manuscript preparation or submission.

Supplementary material

Supplemental data for this article can be access on the publisher’s website.

Notes

^1. The items used a four-point ordinal scale from “not confident at all” to “fully confident,” with the higher numbers associated with greater confidence.

Additional information

Funding

This publication was made possible by Grant [U1QHP28737] from the Geriatric Workforce Enhancement Program (GWEP) of the Health Resources and Services Administration (HRSA), an operating division of the U.S. Department of Health and Human Services.