Welcome to the Hartford Center of Gerontological Excellence at OHSU

In order to meet the complex health care needs of an aging adult population in Oregon and across the Pacific Northwest, we at the Hartford Center of Gerontological Excellence have over twenty years of accomplishments toward meeting our goal to increase the geriatric expertise of providers, faculty, and students put forth by the John A. Hartford Foundation.

Featured news

Carly and Kalisha go to Boston!

Photo of Carly Hernandez Kadell in Boston with poster presentation

Our Hartford Center receives two free registrations to the National Hartford Centers of Gerontological Excellence Leadership Conference as a benefit of membership. This year we supported two students' attendance.

Carly Hernandez Kadell, PMHNP, RN, BSN, BA, (pictured above) is our current Hearst Endowed Scholar. She presented a poster titled, "Screening for Depression Suicidal Ideation in Older Adults: A Review of the Evidence", that summarized the evidence and recommend best practices for screening for depression and suicide ideation in older adults. Prevention of suicide in older adults is a growing health priority in the U.S. Carly's clinical DNP project will investigate this health care crisis. 

Carly wrote, "The conference was a wonderful experiencefor me…The poster session was really helpful - I gained some solid feedback about directions I can go from here, as well as some offers for mentorship. It really was a priceless experience."

Kalisha Bonds, PMHNP-BC, PhD Candidate, attended both the Leadership Conference and Gerontological Society of America (GSA) Annual Scientific Meeting. This year she gave her first GSA podium presentation focused on factors that influence quality of life of both the African American person with dementia and their caregiver.

Kalisha, "love[s] how NHCGNE provides a safe and welcome space to interact with the "who's who" of nursing research. My first publication was through a connection made at NHCGNE."

Attendance at these conferences is an opportunity to learn about the latest research, network with peers, and contribute to strategies that focus on aging well. Our Hartford Center is honored to support our students, the next generation of nurse-leaders.

Hartford Award for Research and Practice

Headshot photo of Hiroko Kiyoshi-Teo

Congratulations to Hiroko Kiyoshi-Teo on her most recent HARP!

Her study, "Fall Prevention in Community-Based Care Facilities: An academic-community partnership", has aims to: identify characteristics of falls and fall-related Emergency Medical Service (EMS) calls from partner residential care facilities (RCF); reduce falls and non-urgent fall-related EMS calls of older adults in RCFs through stakeholder engagement, staff training, and care management; and evaluate feasibility and acceptability of stakeholder involvement with the study process.  

Hiro's research will address two risk factors associated with falls: the relationship between medications and falls, and the relationship between nutrition and falls. This pilot project's interprofessional approach to falls prevention, built upon existing community-academic partnerships, has potential to strengthen those relationships while addressing two significant falls risk factors: polypharmacy and nutrition.

"Falls are not a normal part of the aging process, and most falls can be prevented. Yet, falls are the leading cause of fatal and non-fatal injuries among older adults, causing hip fractures, head trauma, and death (from the Grantmakers in Aging website."

Interprofessional HARP Awarded to Allison Lindauer

Photo of Allison Lindauer in lab coat

Congratulations to Allison Lindauer, Ph.D., N.P., on her Interprofessional Hartford Award for Research and Practice (HARP). Allison, Principal Investigator on the award, is an Assistant Professor at the School of Nursing and the Layton Aging and Alzheimer's Disease Center, where she is also the Director of Outreach, Recruitment, and Education. 

For this project, Layton Center faculty will team up with co-investigators Deb Messecar, Ph.D., M.P.H.,R.N., from the School of Nursing, and Andrew Natonson, M.D., from the School of Medicine. In conjunction with the Oregon Extension for Community Healthcare Outcomes (ECHO) Network, they will provide technology-based mentoring for primary care providers across Oregon. The overarching goal of this interprofessional improvement project is to reduce barriers to diagnosis and care for patients and families living with Alzheimer's Disease or a related dementia (ADRD), especially those in rural or under-served areas.

Dementia diagnosis

At least 65,000 Oregonians carry a diagnosis of ADRD, and over 186,000 spouses, children, and kin provide care for them. However, up to 50% of those with dementia do not know it because under-diagnosis of ADRD is common. Few studies address the ramifications of not knowing a diagnosis. Intuitively, those who do not know their diagnosis can't engage in strategies to delay cognitive impairment and sustain their quality of life. Additionally, families who do know of the diagnosis can receive education and support from their providers, nurses, and peers, and thus, may fare better emotionally and physically. 

Dementia is a growing issue and will continue to be so over the coming decades, especially in rural areas where access to care can be a barrier. The ECHO model is an excellent method through which to educate providers in the optimal care of people with dementia. As the interprofessional team works together, this project has the potential to improve health outcomes for Oregonians living with dementia.

The Hearst Foundations' endowment awarded to three scholars

Our Hartford Center of Gerontological Excellence is proud to announce three new recipients of The Hearst Foundations’ Endowed Scholarship for AY 2019-20. Please join us in congratulating Priya Keane, Allison Miles, and Lisa Pusateri who are all in the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) program. These students will graduate in June with a Master of Nursing degree. They will all continue on in the DNP program in the coming academic year.

Lisa plans to be a leader in the improvement of cancer care and recognizes that cancer treatment can be more challenging and complicated for older adults. Her proposed DNP project is to review the reasons for ER visits by older adult cancer patients and then analyze which visits could have been managed at home or in clinic. Her ultimate goal is to create urgent care protocols that help patients avoid unnecessary ER visits.

Priya is planning her DNP project on patient’s understanding of palliative care, with a focus on what matters to the patient and culturally competent palliative care. Her long-term goal is to participate in an intensive palliative care fellowship for advanced practice providers in Alaska.

Dr. Benjamin Schultze, Assistant Professor and Director of the AGACNP program, wrote, “[Allison] is held in high esteem by not only her peers, but [also] her professors due to her robust academic performance.” Allison’s DNP project plans to retrospectively investigate whether early pressor use versus liberal fluid resuscitation changed overall sepsis mortality.

As our population ages it becomes vital that nurses, the largest segment of the nation’s health care system, be trained and competent in the care of older adults. These three outstanding nurses exemplify the passion and compassion, professionalism, dedication to excellence, and critical thought required of our next generation of nurse leaders.

Since 2002, $397,680 has been awarded to 63 graduate students who are in preparation to become the next generation of advanced practice nurses in the field of geriatrics. The Hartford Center of Gerontological Excellence is honored to steward this significant endowment.

2019 HARP call for proposals

Our OHSU Hartford Center of Gerontological Excellence (HCGE) 2019 call for School of Nursing faculty proposals for our Hartford Award for Research and Practice (HARP) is now open. For the HARP program, faculty applicants must have a clinical or research doctorate and their focus must be on improving the health and health care of older adults through research and/or innovations in care. The deadline for completed proposals is May 17, 2019 before 5:00 p.m. The "HARP Call for SoN Faculty Proposals 2019" details the proposal criteria, expectations, guidelines, and eligibility. This small grants program awards one-year grants of up to $25,000.

In his November 1, 2018 Listening Tour Town Hall, Danny Jacobs, M.D., M.P.H., F.A.C.S., OHSU President, quoted an old saying, "If you want to go fast, go alone; if you want to go far, go together." Our team-science focused, Interprofessional HARP (IP HARP) call for proposals is also open. For the IP HARP program, faculty applicants must have a clinical or research doctorate and their focus must be on improving the health and health care of older adults through research and/or innovations in care. The IP HARP is offered to all OHSU faculty, including those with full-time appointments at the Schools of Nursing, Dentistry, Public Health, Medicine, and College of Pharmacy. If the proposed Principal Investigator (P-I) holds a primary appointment outside of the School of Nursing, there must be a Co-Investigator (Co-I) representing the School of Nursing. An interprofessional research team is a requirement of this award. The deadline for completed proposals is May 17, 2019 before 5:00 p.m. The "IP HARP Call for OHSU Faculty Proposals"  outlines proposal criteria, expectations, guidelines, and eligibility.

Our first IP HARP was awarded to P-I, Richie Kohli, B.D.S., M.S., Assistant Professor, School of Dentistry, and Co-I, Paula Gubrud-Howe, Ed.D. R.N., Associate Professor, School of Nursing. Their pilot study, "Oral Health Clinical Training and Dental Referral Program for Nurses in Oregon: An Interprofessional Collaborative Project", created an IP training program for nurses to screen the oral health of their patients. Stay tuned for reports on their findings!

We are grateful to the Frances Price Estate and OHSU Foundation's continued support of our research mission.

If you have questions or would like more information, please contact Marilyn Sanguinetti, HCGE Project Administrator, at sanguine@ohsu.edu

JAHF - 30 years of grant-making

Two reports just released about the John A. Hartford Foundation (JAHF) provide an overview their accomplishments in the field of geriatrics over the last 30 years.

One was published in Health Affairs this January and written by Stephen Isaacs, Paul S. Jellinek and Terry Fulmer. "The JAHF and the Growth of Geriatrics" is a synopsis of an evaluation commissioned by the JAHF in 2017. The full report, "Assessment of the Accomplishments and Impact of the John A. Hartford Foundation's Grantmaking in Aging and Health: 1983 - 2015" was prepared by Isaacs/Jellinek, a division of Health Policy Associates.  

They got me thinking about what the JAHF has meant to our Hartford Center and the differences we have made, and continue to make, with the generous support of our School of Nursing and the OHSU Foundation. (Our JAHF funding ended in 2016.)

Through 2015 the nine geriatric nursing centers were awarded 280 prestigious pre- and post-doctoral fellowships. Our OHSU Hartford Center had 25: 20 pre-docs and 5 post-docs. Of the 14 pre-doctoral graduates I have been able to contact, 12 are currently on the faculties of nursing schools, including several here!

For more on the JAHF's impact on geriatric nursing check out page 22 of the final report, but these are the highlights, "…[their] interlocking strategies created a cadre of geriatric nursing scholars and educators, fostered strong and enduring geriatric nursing institutions and programs, and embedded geriatrics content in nursing education and credentialing."

Our Hartford Center also brought opportunities for geriatric training and scholarship to post-masters nurses through a PMCO-Advanced Practice Gerontological Nursing program; to undergraduate (UG) faculty through several programs including a summer "Faculty Scholars" program, ACES (Advancing Care Excellence for Seniors) training, a two-day FLAG (Facilitated Learning through Advanced Geriatrics) workshop; and to ALL students. The UG Gerontological Nursing Honors Program, currently in its final year, will have graduated 35 students by year's end. They will all bring to their practice gerontological expertise that goes beyond our baccalaureate curriculum. These nurses live in all regions of our State and two honors graduates are currently on faculty!

We are grateful for our OHSU Foundation's continued support of our research mission through the endowed "Hartford Award for Research and Practice" (HARP). For the HARP program, faculty applicants must have a clinical or research doctorate and the focus must be on improving the health and health care of older adults through research and/or innovations in care. The Calls for Proposals are open until May 17, 2019! For more information please contact Marilyn Sanguinetti.