LITTLE ROCK GRECC FY 03 HIGHLIGHTS

I. Collaboration With Other VA Entities

-   Dr. Sullivan continues to serve on the VACO Geriatrics & Extended
    Care Task Force Committee

-   Dr. Chernoff joined the VISN Geriatrics & Extended Care Task Force
    Committee as a representative from the GRECC

-   Geriatric staff at Houston and Oklahoma City VAMCs have asked that
    we provide mentoring to their staff by VTC our research conference
    to their sites monthly.

-   Drs Sullivan and Chernoff presented to the VISN ELC regarding the
    GRECC program and the above VISN education initiative.

-   In collaboration with the VISN 16 LTC Committee and ELC, the LR
    GRECC developed a program to provide on-site training of the
    Geriatric staff at all 10 facilities in this VISN during FY03

-   Dr. Hart is very involved with the VISN 16 MIRECC on several pilot
    projects --VISN-wide Neuroimaging retreat

-   Measuring the hippocampus: A comparison of alternative methods.
    South Central MIRECC, Tulane Univ. Health Sciences Center, PI is
    David Corey, Ph.D.

-   A geriatrics curriculum for surgical residents was developed and is
    now a mandatory component of the surgical residents' orientation

-   In collaboration with the AGEC developed a self-study in geriatrics
    that is open to all VISN 16 health professionals.

-   Developed and implemented a monthly Morbidity & Mortality Conference
    for all of Geriatrics and Extended Care

-   Dr. Sullivan served as Acting ACOS for Geriatrics and Extended Care
    this FY

-   Collaborating with the VISN EES Coordinator

-   We have included other Services in our programs, enhancing the
    relationships between those Services (General Surgery, Social Work,
    Neurology, RMS, Urology, Nursing) and the GRECC. We have also
    supported and provided students for other Services, although the
    students have focused on geriatric care aspects of whatever
    discipline students were in through GRECC traineeships.

## II. Aging Research

-   The Little Rock GRECC has active basic biomedical, applied clinical,
    and health services research programs:

-   \$7,598,828 in research funding during last FY - Represents over \$3
    million in VERA funding

-   62 publications, 51 grants including 2 program projects and one
    Center grant last FY

-   Dr Sue Griffin's research identified a strong link between
    Alzheimer's disease and a disordered inflammatory response

-   Drs. Evans and Sullivan found that anabolic hormone commonly used to
    treat weight loss in older adults caused fat gain, but loss of
    muscle mass and function

-   Dr. Evans' research team continues to set standards for exercise and
    special diets for older adults

-   Dr. Sullivan's research team determined that nutritional
    deterioration due to inadequate nutritional support during
    hospitalization very common among older patients leading to
    increased mortality risk

**Number range CHAPTERIII. Education and Training**

-   We have offered approximately 34 hours of professional continuing
    education through conferences and video teleconferences:

-   Three continuing education conferences - Geriatric Medicine Update:
    Cancer in the Elderly; Best Practices in the Continuum of Care:
    Patient Safety; *Nutrition and Aging XVIII*: Obesity in Older Adults

-   Four video teleconferences -- Dementia Diagnosis; Incontinence;
    Dementia Management; Smoking Cessation, Air Quality and Policy in
    Older Adults

-   A training program for rural health practitioners in Arkansas called
    the Arkansas Geriatric Education Mentors and Scholars (AR-GEMS)
    program

-   Geriatrics curriculum was developed for surgical residents now a
    mandatory component of the surgical residents' orientation and will
    soon be exportable to all VISN facilities as described above

-   Conducted a VISN-wide facility needs assessment

-   In collaboration with the VISN 16 LTC Committee and ELC, the LR
    GRECC provided on-site training of the Geriatric staff at all 10
    facilities in this VISN during FY03

-   The Arkansas Geriatric Education Center grant was renewed for 5
    years in 2002 - for \$2.1 million.

-   Awarded a supplemental GEC grant - \$100,000

-   Hired Education Specialist -- Mary Sue Farmer, MSE, assumed this
    position in June, 2003

-   There were 135 health professionals from VISN 16 who attended GRECC
    educational events

## IV. Clinical Demonstrations Models/Best Practices

-   We continue to manage the scope of clinical geriatric programs at
    this facility:

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-   Geriatric Fellowship Program, during FY03 there were 5 fellows.

-   The LR GRECC hosts a Special Fellowship Program in Advanced
    Geriatrics in which we filled 2 slots

-   As part of the mandatory third-year medical school Geriatrics
    rotation, all junior medical students rotate through the North
    Little Rock Division clinical programs.

-   Established a Memory Disorders Clinic, which continues to grow in
    size, scope, and complexity

-   Developed a Mentoring and training program for all of the Medical
    Directors of each Geriatric program (including the GEM, NHCU, ADHC,
    & clinic)

-   Outcomes indicators developed in NHCU and GEM during FY03 -
    Implemented process to capture admission and discharge FIM
    functional assessment scores on all patients admitted to the GEM
    Unit; Developed a process to capture how many patients get
    appropriate pain assessments on GEM; Currently refining a process to
    monitor how effectively pain is managed; Developed a process to
    capture amount of time NHCU residents are out of bed

-   Nutrition Initiative: Purpose to discover reasons for failure of
    nutrition repletion efforts.

-   The GRECC provided close mentorship of the Geriatric Clinical
    faculty, helping them to build the largest VA-based Geriatric
    program in the nation with over 5,200 veterans enrolled

-   has implemented an automated preventative health maintenance system
    in the ADHC

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## V. Dissemination of GRECC Products

-   Videotapes from video teleconferences produced by the GRECC in
    collaboration with the Arkansas GEC (AGEC) were distributed to each
    VISN 16 facility for continuing education

-   4 interactive television video teleconferences broadcast to all
    VAMCs in our VISN

-   There were syllabus materials produced from the 3 conferences

-   Videotapes produced from Dr. Lipschitz's PBS television series,
    *Aging Successfully*

-   New video-teleconferencing system, has allowed us to provide our
    clinical and research staff at NLR the capability of participating
    in grand rounds and other educational activities broadcast from
    LR/VISN/UAMS.