UNC’s 4th cohort of Interprofessional Geriatrics Fellows featured a cardiologist, a doctor of nursing practice, a pharmacist and a dental hygienist learning as a team about best practices of person-centered interprofessional geriatric medicine. On May 6, they wrapped up their 2018-2019 fellowship year with an insightful look at what makes a health care provider’s office “geriatrics friendly.”
Roxanne D’souza, RDH, MS, Heather Johnson, DNP, Jessica Robinson, PharmD, and Beth Rosenberg, MD, EdD, presented the results of a year-long qualitative study to identify the features of clinic visits that best accommodate needs of older adults. They conducted semi-structured interviews and focus groups with patients and clinic staff along with site visits in diverse locations throughout the state.
Challenges to Consistent and Effective Care for Older Adults
Among some of the challenges that impact the health and independence of community-dwelling older adults are falls, medication errors and non-adherence to meds, inadequate communication, and inability to access primary care providers.
Having consistent access to safe and comfortable environments for primary care services is key to older adults’ ability to continue to live in their homes and communities. The Fellows found that amidst a bevvy of guidelines covering all aspects of medical care for older adults, few guidelines exist to delineate a clear framework to ensure easy, safe, and effective primary care outpatient visits.
Recommendations for Creating Ideal Older Adult Outpatient Clinic Visits
The study recommends finding ways to increase:
- Advocacy for patients lacking caregiver support
- Streamlining of services provided during clinic and limiting wait times
- Pharmacist-led medication reconciliation and access to social workers
- Consistent, effective communication between internal and external providers
- Interpersonal communication that allows patients to feel comfortable expressing their concerns
- Transportation options that shorten the time spent traveling to appointments
- Culturally-competent care (e.g., multi-lingual in-clinic resources)
Our IPE Fellows’ work highlighted the need to form strong therapeutic alliances between multiple disciplines, respect possible low health literacy, plan care around the patient’s goals, and support caregivers as health care navigators and advocates.
The Fellows will prepare their findings for publication and share actionable items with clinics throughout the area.
The Center for Aging and Health is proud of the hard work and achievements of our IPE Geriatrics Fellows. Through their efforts, and through programs such as UNC’s Interprofessional Geriatrics Fellowship, more older North Carolinians — including those in underserved or rural areas — will receive high-quality care that is informed by best practices and recent research in geriatric medicine.