Addressing the Critical Shortage of Geriatric Health Care Leaders Eric A. Coleman, MD, MPH, AGSF, FACP Professor of Medicine Executive Director, Practice Change Fellows Program University of Colorado Denver

Program Overview Build leadership capacity among health care professionals with operational responsibility for aging programs & geriatric service lines 8-10 Fellows selected in annual competition Nurses, Physicians, Social Workers Highly engaged National Advisory Board Foster national network and platform for change Supported by Atlantic Philanthropies & John A. Hartford Foundation

What is Approach? Incorporate leadership development into day job Convene in person three times per year Expand the mentor-mentee dyad—mentoring pods Project is a vehicle for leadership development augmented by a formal learning contract Attend customized national leadership experience Supported by Atlantic Philanthropies & John A. Hartford Foundation

Six Skill Seminars for System Change Compelling outcomes for program sustainability Presenting a compelling business case Building high performing teams Fostering cross setting collaboration Leading cultural change Negotiating conflict Supported by Atlantic Philanthropies & John A. Hartford Foundation

Practice Change Fellows Program Logic Model Resources & InputsStrategiesFellows’ Short-term Outcomes Impact on Fellows’ Home Organization Cumulative Long- term Impact Fellows Fellows’ projects Fellows’ home organizations Advisory Board Program Office Atlantic Philanthropies + John A. Hartford Foundation Program curriculum National Leadership Training Evidence based models Evaluation External Leadership Course Fellows’ Project Support Fellows’ Workplan and Contract Dissemination by Program Office or by National Advisory Board Members Career Advancement In the Home Institution Fellows’ Awareness Knowledge Skills Fellows Project Additional Dissemination of Projects Organizational Leaders Responsive Improved Capacity for Serving Older Adults Fellows’ Longer-term Outcomes Improved Health Outcomes for Older Adults PCF Leadership Training Improved Efficiency in Serving Older Adults Improved outcomes Broader Influence Of Home Organization Improved Care and Enhanced Value in Health and Health Care for Older Adults

Diffusion of Innovations Diffusion of innovations is a theory of how, why, and at what rate new ideas and technology spread Central role of leadership to evaluate among evidence based approaches and customize to unique settings Supported by Atlantic Philanthropies & John A. Hartford Foundation

Translation of Evidence Based Models (T2/T3) Fellows (and Advisory Board) well positioned to implement evidence-based models in their home organizations and beyond –Chronic Disease Self-Management Program –BOOST (Better Outcomes for Older Adults Safe Transitions) –Care Transitions Intervention Supported by Atlantic Philanthropies & John A. Hartford Foundation

Bridging Practice Change and Health Policy Whether through legislative or regulatory approaches, delivery system reform cannot be successful without the experience and expertise of practice leaders. Fellows and Advisory Board understand how to implement a patient-centered medical home, an accountable care organization, a bundled payment approach, and strategies to realize the potential of health information technology. Incorporate activities that serve to amplify the program’s influence at this critical interface between practice and health policy. Supported by Atlantic Philanthropies & John A. Hartford Foundation

Evaluation Gains in Skills (scale 1-5) Business case pre 2.65/post 4.35 Lead quality improvement pre 3.20/post 4.35 Engage support of senior leadership pre 3.30/post 4.50 Align goals of key stakeholders pre 3.05/post 4.30 Describe a specific policy or regulatory barrier to practice improvement pre 2.50 /post 3.60 Supported by Atlantic Philanthropies & John A. Hartford Foundation

Evaluation Home Supervisor Fellows’ project has become incorporated=90% Beyond the PCF project, the Fellow has garnered financial support from the organization for further practice change efforts=90% Fellows’ project has improved health-related outcomes for older adults=80% Fellows’ change efforts are having a positive impact beyond our organization=80% Supported by Atlantic Philanthropies & John A. Hartford Foundation

Evaluation Alumni Project implemented=100% Project demonstrated improvement in outcomes for older adults=100% Project saved home organization $$$ (40%) Supported by Atlantic Philanthropies & John A. Hartford Foundation

Evaluation Meeting Attendance Advisory Board rate of attendance =93% –Gain cutting edge content –Foster next generation –Interact with one another –Be part of something larger Supported by Atlantic Philanthropies & John A. Hartford Foundation

Financial Leverage Match from Fellows’ home institution ($1.7M) Fellows’ leverage ($2.3M) Supported by Atlantic Philanthropies & John A. Hartford Foundation

Dan Reece, MSW (PeaceHealth) Ilaina Edison, RN, MBA (Visiting Nurses Services) Eran Metzger, MD (Hebrew Senior Life) Supported by Atlantic Philanthropies & John A. Hartford Foundation Illustrative Examples

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