Transformational efforts to redesign the care system for older adults call for the development of novel partnership models incorporating academic institutions, primary care networks, and community-based organizations. The Rhode Island Geriatric Workforce Enhancement Program (RI-GWEP) has utilized the “resource exchange model” to develop innovative, interdisciplinary, and integrated projects combining educational resources, clinical expertise, programmatic experience, and impact evaluation. With particular emphasis on the challenges of developing interprofessional education spanning the traditional gaps between disciplines and departments, this presentation emphasizes the critical conditions, components, and capacities of such a collaborative network. These include: (1) mission dominance, (2) barter exchange, (3) partnership investment, and (4) interpersonal relationships. RI-GWEP’s experience provides insights into the conceptual foundation of geriatrics networks and specific, concrete examples of projects incorporating these principles. Implications for the development of networks in other settings include consideration of particular: (1) projects, (2) people, (3) places, (4) personalities, and (5) possibilities.
In 2015 the Rhode Island Geriatric Education Center (RIGEC) was one of 44 organizations funded by HRSA to implement the Geriatrics Workforce Enhancement Program (GWEP). A primary objective was to develop and deliver Alzheimer’s Disease and Related Dementias (ADRD) education to patients, families, caregivers, and health professionals, with a focus on special populations. Concurrently, Seven Hills Rhode Island, a nonprofit agency that serves people with disabilities, received a grant from the Administration for Community Living (ACL) to provide education and resources to health professionals and caregivers of people with I/DD. As goals for both projects aligned closely, they worked together, fostering a strong partnership, amplifying the opportunity to offer high-quality educational programs and reach target audiences. Lessons learned from this networked approach are critical to informing sustained improvements to the I/DD and health care systems in subsequent GWEP projects.
The ECHO model is uniquely suited to developing education for a wide range of agencies and providers serving the needs of older adults with IDD. The program’s structure and its educational philosophy depend on modeling teamwork in both the hub and the spokes. Recruitment of participants included paid caregivers, healthcare practitioners, and direct service providers, focusing on team participation at each site. In developing the curriculum, it was critical to recognize the roles played by each sector, as well as the complementary contributions of others. Consequently, curriculum content needed to be multidisciplinary and multifocal, and recognize both the breadth of contributors and time limits in selecting content for each session. Didactic presentations and case studies embodied these features. Priorities included best practices in person-centered care; differential diagnoses; and physical, social, and environmental factors. The facilitators of, and challenges to, these priorities offer implications for advancing educational programs with similar objectives.
Health and social care providers are ill-equipped to address the complex needs of individuals growing older with IDD and their families when dementia is suspected or diagnosed. Addressing the growing need for professionals to acquire practical diagnostic, treatment, and management methods requires an interorganizational and interprofessional approach. A consortium of aging and IDD organizations developed a successful Project ECHO (Extension for Community Healthcare Outcomes) model to create a virtual community of practice connecting a hub team and participating spoke sites. This paper reviews reasons for the model’s success, including: (1) curriculum providing practical solutions to complex problems, (2) integration of interprofessional team approach, (3) “all teach, all learn” model promoting sharing among participants, and (4) the inclusion of case studies engaging participants in developing solutions and strategies to improve the quality of life of clients and families. Implications of this model and recommendations for future professional educational programs are presented.
As individuals with I/DD live longer, Alzheimer’s disease is on the rise, particularly in individuals with Down syndrome. Practitioners have recognized that the I/DD system does not possess the expertise to provide appropriate care for this population as it ages. A series of federally funded initiatives in Rhode Island – supported by the Centers for Medicare and Medicaid Services (CMS), the Administration for Community Living (ACL), and the Health Resources and Services Administration (HRSA) -- have begun to equip health care and direct care professionals to meet the needs of individuals with I/DD and AD. Using a “connector” model, the GWEP at RIGEC has woven together these efforts, aligned program goals from disparate funders, built connections between the Aging Network and the disability system, and worked with the National Task Group on Intellectual Disabilities and Dementia Practices (NTG) to create sustainable resources for the health care and direct care workforces.
Ongoing evaluations of innovative educational programs provide opportunities for quality improvement. This paper reports results from a Project ECHO series on lifelong IDD and dementia. Participant responses (n = 85) were collected from spoke sites in various settings across the US. Using a 5-point (5 very effective) Likert scale, data were collected from assessment items on 4 didactic presentations and 5 case studies representing essential components of the ECHO model. Overall scores by spoke sites for satisfaction with the didactic and case presentations ranged from 3.94 to 4.94; relevance of case studies to the work setting ranged from 4.0 to 4.75. Knowledge gain questions showed consistently positive directionality. As a result of their participation, spokes rated intent to provide better care for patients (57% to 88%), train staff (62% to 81%), and educate family/caregivers (57% to 88%). Implications of findings for the application of quality improvement methods are discussed.
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