Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

Tumosa, Nina; Horvath, Kathy J.; Huh, Terri J.; Livote, Elayne; Howe, Judith L.; Jones, Lauren; Kramer, B. Josea

doi:10.1080/02701960.2012.661812

Cited by 15 publications

(6 citation statements)

References 11 publications

(6 reference statements)

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“…[70] described a programme of rural education that requires participants to complete a survey to assess individual educational needs. The needs analysis was used to then design an appropriate mix of clinical, didactic, supervised and administrative learning experiences.…”

Section: Resultsmentioning

confidence: 99%

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

et al. 2014

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ObjectiveTo identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts.DesignThis is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts.ResultsThis review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme.ConclusionThrough a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts.

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Section: Resultsmentioning

confidence: 99%

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

et al. 2014

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“…These QI performance measures were based on geriatric-focused clinical practice guidelines or quality indicators and reflect topics of QI projects that were commonly implemented by the Geriatric Scholars prior to our involvement in the program. 23 The current suite of GSP clinical dashboards actively in use in the VA identify patients at risk for pneumococcal disease, geriatric psychiatric admissions, ambulatory care sensitive condition (ACSC) hospitalizations, osteoporosis, and adverse drugs events due to inappropriate prescribing ( Fig. 2 ).…”

Section: Methodsmentioning

confidence: 99%

Developing the VA Geriatric Scholars Programs' Clinical Dashboards Using the PDSA Framework for Quality Improvement

et al. 2022

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Background Involving clinician end users in the development process of clinical dashboards is important to ensure that user needs are adequately met prior to releasing the dashboard for use. The challenge with following this approach is that clinician end users can undergo periodic turnover, meaning, the clinicians that played a role in the initial development process may not be the same individuals that use the dashboard in future. Objectives Here, we summarize our Plan, Do, Study, Act (PDSA)-guided clinical dashboard development process for the VA Geriatric Scholars Program (GSP) and the value of continuous, iterative development. We summarize dashboard adaptations that resulted from two PDSA cycles of improvement for the potentially inappropriate medication dashboard (PIMD), one of many Geriatric Scholars clinical dashboards. We also present the evaluative performance of the PIMD. Methods Evaluation of the PIMD was performed using the system usability scale (SUS) and through review of user interaction logs. Routine end users that were Geriatric Scholars and had evidence of 5 or more dashboard views were invited to complete an electronic form that contained the 10-item SUS. Results The proportion of Geriatric Scholars that utilized the PIMD increased for each iterative dashboard version that was produced as a byproduct from feedback (31.0% in 2017 to 60.2% in 2019). The overall usability of the PIMD among routine users was found to be above average (SUS score: 75.2 [95% CI 70.5–79.8]) in comparison to the recommended standard of acceptability (SUS score: 68) Conclusion The solicitation of feedback during dashboard orientations led to iterative adaptations of the PIMD that broadened its intended use. The presented PDSA-guided process to clinical dashboard development for the VA GSP can serve as a valuable framework for development teams seeking to produce well-adopted and usable health information technology (IT) innovations.

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“…A national group of interdisciplinary geriatric specialists within the VHA Geriatric Research, Education, and Clinical Centers developed the VA Geriatrics Scholars Program (GSP), a national workforce development training program to integrate geriatrics into primary care practices 20,21 . This program delivers evidence‐based educational programs to post‐licensed providers.…”

Section: Introductionmentioning

confidence: 99%

Improving Geropsychology Competencies of Veterans Affairs Psychologists

Huh

Rodríguez

Gregg

et al. 2021

J American Geriatrics Society

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Older adults are more likely to seek mental health care through integrated care settings such as primary care. Currently, there exists a significant shortage of mental health providers trained in geropsychology and integrated care competencies. To address this need within the Veterans Health Administration, a national workforce development program was extended to include psychologists, which is called the Geriatric Scholars Program‐Psychology Track (GSP‐P). The GSP‐P has two overarching educational program aims: (1) to improve geropsychology competencies of practicing VA psychologists, particularly those working within integrated settings (e.g., primary care) and (2) enrich psychologists' abilities to enact change in their clinical settings. Ninety‐eight VA clinicians participated in the GSP‐P, which includes a multi‐day in‐person course, from 2014 to 2018. Participants completed measures assessing confidence and self‐reported knowledge in geropsychology and integrated care competencies pre‐course and 3‐months post‐completion. Two‐weeks post‐course participants responded to open‐ended survey questions regarding their perceptions of the course and potential applications of learning. Significant improvements in confidence in and knowledge of geropsychology and integrated care competencies emerged from pre‐course to 3‐months post‐completion. Qualitative findings demonstrated that participants valued the face‐to‐face, integrated multimodal educational program. Findings provided insights regarding clinicians' planned application of the knowledge acquired, such as modifying treatments for older patients. Specialized workforce programs such as the GSP‐P have a significant, positive impact on the care of older Veterans.

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Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

Cited by 15 publications

References 11 publications

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

Developing the VA Geriatric Scholars Programs' Clinical Dashboards Using the PDSA Framework for Quality Improvement

Improving Geropsychology Competencies of Veterans Affairs Psychologists

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