CAROLINA GERIATRIC WORKFORCE ENHANCEMENT PROGRAM (CGWEP)

The Center for Aging and Health at UNC received a five-year grant from the Health Resources and Services Administration to integrate geriatrics into primary care and expand interprofessional education in geriatrics.

CGWEP leadership is provided by the UNC School of Medicine’s Center for Aging and Health. Jan Busby-Whitehead, MD, is program director and principal investigator. Ellen Roberts, PhD, MPH, serves as associate program director. Cristine (Clarke) Henage, EdD, serves as Assistant Director. Visit the Meet our Staff page to learn more.

Partners include East Carolina University College of Nursing, the NC Area Health Education Centers (AHEC) Program and all nine regional AHEC partners covering 100 counties in North Carolina. Continuing education for health care professionals and families is provided by Area L, Charlotte, Eastern, Greensboro, Mountain, Northwest, Southern Regional, Southeast and Wake. AHECs, along with the North Carolina Division of Aging and Adult Services and UNC Schools of Medicine, Nursing, Social Work, Dentistry, Pharmacy and Public Health, help the CGWEP build bridges between the clinic and the community.

Since 2010 continuing Geriatrics education through the CGWEP and its predecessor, the Carolina Geriatric Education Center (CGEC), has trained over 43,000 health professionals from all levels in medicine, nursing, pharmacy, social work, public health, dentistry, allied health, and health administration.

Clinical Priorities

The Carolina Geriatric Workforce Enhancement Program is reaching out to primary care practices to ensure every provider has geriatrics knowledge. The CGWEP has 5 clinical priorities:

Falls

Decreasing the incidence of falls in primary care and presenting to the emergency room

Falls is a quality measure that has long been a goal of the CGWEP. Between 2010 and 2015 we partnered with Mountain AHEC and Physical Therapy faculty from Western Carolina University to implement standardized falls risk screening for all patients over the age of 65 in 3 physician practices in the western part of North Carolina. In the summer of 2012 we reported an increase of 37% in falls screening rates showing a demonstrated improvement in practice and ultimately outcomes. Our research results were featured in 2 posters at the Gerontological Society of America.

Advance Care Planning

Increasing the use of advance care planning

In Wilmington our partners at Southeast Area Health Education Center increased the number of older adults who have advance care planning conversations with their providers, scanned written documents in their electronic health records or a billed advance care planning visit. This project has been expanded to 51 clinics in the UNC Physicians Network.

Opioids and Benzodiazepines

Decreasing high risk medications like opioids and benzodiazepines

With additional funding from the Centers for Disease Control the CGWEP has partnered with the UNC School of Pharmacy to reduce long term use of these medications that hold a higher falls risk for older adults.  This project will randomize primary care clinics into two arms. The intervention clinics will receive additional consultation from expert Pharmacists from the UNC CAMP team while the control clinics will pursue usual care. The research is expected to show a reduction in the prescribing of these drugs and perhaps a reduction in the rate of falls for patients at the intervention clinics.

Diabetes

Decreasing the number of patients with out-of-control diabetes (A1C higher than 9)

The CGWEP is partnering with Piedmont Health Services, Inc, a federally qualified health center that serves rural and low income patients to reduce the percentage of diabetic patients with out of control A1Cs. Geriatricians, Family Medicine Physicians, Advance Practice Providers, Nurses and Nutritionists have teamed up to implement the American Diabetes Association Clinical App as part of this intervention. Interprofessional healthcare providers will receive telementoring on managing their diabetic patients via a regular videoconferencing meeting with endocrinologists and other experts.

For more information about Geriatric Education Centers check out the National Association for Geriatric Education.