John A. Hartford Foundation Centers of Excellence Program: History, Impact, and Legacy

Reuben, David B.; Kaplan, Daniel B.; Willik, Odette van der; Brien‐Suric, Nora O

doi:10.1111/jgs.14852

Cited by 7 publications

(4 citation statements)

References 1 publication

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“…Currently, there is an establishment of geriatric centers of excellence regarding internal medicine. 19 However, there has not yet been a categorization of specifically TCs of excellence in the care of the geriatric patient. Implementation of Acute Care for the Elderly (ACE) units has been shown to improve many aspects of hospitalization, such as cost, length of stay, readmission rates, utilization, rehabilitation, cognition, function, and overall patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Geriatric Trauma Mortality: Does Trauma Center Level Matter?

Rogers

Morgan

Brown

et al. 2020

The American Surgeon™

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Background Given their mostly rural/suburban locations, level II trauma centers (TCs) may offer greater exposure to and experience in managing geriatric trauma patients. We hypothesized that geriatric patients would have improved outcomes at level II TCs compared to level I TCs. Methods The Pennsylvania Trauma Outcome Study (PTOS) database was retrospectively queried from 2003 to 2017 for geriatric (age ≥65 years) trauma patients admitted to level I and II TCs in Pennsylvania. Patient demographics, injury severity, and clinical outcomes were compared to assess differences in care between level I and II TCs. A multivariate logistic regression model assessed the adjusted impact of care at level I vs II TCs on mortality, complications, and functional status at discharge (FSD). The National Trauma Data Bank (NTDB) was retrospectively queried for geriatric (age ≥65 years) trauma admissions to state-accredited level I or level II TCs in 2013. Results 112 648 patients met inclusion criteria. The proportion of geriatric trauma patients across level I and level II TCs were determined to be 29.1% and 36.2% ( P <.001), respectively. In adjusted analysis, there was no difference in mortality (adjusted odds ratio [AOR]: 1.13; P = .375), complications (AOR: 1.25; P = .080) or FSD (AOR: 1.09; P = .493) when comparing level I to level II TCs. Adjusted analysis from the NTDB (n = 144 622) also found that mortality was not associated with TC level (AOR: 1.04; P = .182). Discussion Level I and level II TCs had similar rates of mortality, complications, and functional outcomes despite a higher proportion (but lower absolute number) of geriatric patients being admitted to level II TCs. Future consideration for location of centers of excellence in geriatric trauma should include both level I and II TCs.

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Section: Discussionmentioning

confidence: 99%

Geriatric Trauma Mortality: Does Trauma Center Level Matter?

Rogers

Morgan

Brown

et al. 2020

The American Surgeon™

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“…Beginning in 1988, to support efforts to increase the number of geriatrics-trained faculty and training initiatives in geriatrics focused on medical students and residents, the John A. Hartford Foundation and the Donald W. Reynolds Foundation combined to invest nearly $160 million. 3 However, in 2011, the Hartford Foundation made a strategic decision to pivot away from supporting efforts to build academic capacity in geriatric medicine to fund more broadly focused health system initiatives. The other major funder of geriatric educational programs, the Reynolds Foundation, closed down permanently having spent down all of its assets.…”

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confidence: 99%

The Paradoxical Decline of Geriatric Medicine as a Profession

Gurwitz

2023

JAMA

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“…These leaders' passion, dedication, and creativity will guide our healthcare and social systems in new directions to assure that we can grow older with dignity and well-being. [1][2][3][4][5][6][7][8] Their work builds on the momentum of past leaders in aging. Their efforts will (1) pioneer new models of care, (2) prepare the healthcare workforce to care for older persons, (3) advance research on aging, and (4) engage the community to make neighborhoods safer for older persons to thrive.…”

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confidence: 99%

“…Changing family structures, advances in technology, unprecedented cultural diversity, new perspectives on health, and increasing need for community‐based support systems requires a new generation of leaders committed to creating new solutions to evolving concerns faced by many older adults. These leaders’ passion, dedication, and creativity will guide our healthcare and social systems in new directions to assure that we can grow older with dignity and well‐being . Their work builds on the momentum of past leaders in aging.…”

mentioning

confidence: 99%

Leadership, Inside and Out: The Tideswell‐AGS‐ADGAP Emerging Leaders in Aging Program

Chang

Lundebjerg

Abrams

et al. 2019

J American Geriatrics Society

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BACKGROUND/OBJECTIVES To optimize health and well‐being for all older people, we must collectively develop leaders to pioneer models of care, educate the healthcare workforce, advance research, and engage the community. METHODS The Emerging Leaders in Aging (ELIA) program was created to train a multiprofessional cadre of leaders focused on the health and well‐being of older people. ELIA uses the social change curricular framework and addresses knowledge of self, community, and engagement with change. Program impact measured included scholar satisfaction, confidence related to curricular domains before and after the program, project progress, and scholar productivity. RESULTS Four cohorts of 65 scholars in seven health professions from 24 states were selected for the year‐long 55‐hour program. Overall satisfaction from members of the first three cohorts who have completed the program (n = 46) was 4.86 (scale = 1–5), and scholar confidence increased from 5.8 to 8.0 (scale = 1–9) (p < .001). These scholars reported 85 presentations, 63 publications, and 21 awards subsequent to training. All scholars described the importance of a program focused on early and mid‐career leaders in health and aging. DISCUSSION The ELIA program leverages longitudinal, distance mentor communities, and project‐based learning strategies. It has improved confidence and skills in emerging leaders who commit their efforts toward the care of older persons. Programs like ELIA are critical to preparing a healthcare workforce to optimize care for all as our health needs and expectations change with age. J Am Geriatr Soc 67:437–442, 2019.

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John A. Hartford Foundation Centers of Excellence Program: History, Impact, and Legacy

Cited by 7 publications

References 1 publication

Geriatric Trauma Mortality: Does Trauma Center Level Matter?

Geriatric Trauma Mortality: Does Trauma Center Level Matter?

The Paradoxical Decline of Geriatric Medicine as a Profession

Leadership, Inside and Out: The Tideswell‐AGS‐ADGAP Emerging Leaders in Aging Program

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