Monthly Archives: November 2011

JAHF and NAGEC Meet to Plan New Strategies

The John A. Hartford Foundation (JAHF) and the National Association of Geriatric Education Centers (NAGEC) recently convened an intensive one-day strategic planning session with twenty key representatives from around the nation. Participants included leaders in geriatrics and geriatrics education, palliative medicine, nursing, public health, planning, and public policy, as well as the Hartford Foundation’s executive staff. Meeting at Foundation headquarters, the group shared experiences in their fields and generated ideas to enhance and improve the work of the Geriatric Education Centers (GEC). The result was a decision to move in new directions.

In his opening remarks, the Foundation’s Program Director, Christopher Langston, PhD, set the tone: “We have to look at the big picture,” he said. Let’s face it—available monies are greatly diminished when compared to ten years ago. We have to develop non-financial powers. What do I mean by this? I mean convening people; developing new synergies, ideas, and plans; and identifying how the various sectors of society can work together. We must work to determine where our interests and missions intersect and then be able to move forward to create partnerships in new places.”

The meeting revolved around three broad areas: developing partnerships, conducting outcome evaluations, and retooling for an aging America. The morning session included participant speakers, who gave concise topic summaries. Langston provided an overview of the Institute of Medicine’s report, Retooling for an Aging America. Roseanne Leipzig, MD, PhD, of the Brookdale Department of Geriatrics and Palliative Medicine, presented a brief survey of the geriatric education initiative. Janet Frank, DrPH, of the David Geffin School of Medicine at UCLA, discussed developing partnerships to extend GEC. Julia Hannum-Rose, PhD, Professor of Medicine and Palliative Care, Case at MHMC, spoke about current NTACC resources in support of GECs.

Participants then divided into three breakout discussion groups to confer about their assigned issues and develop recommendations for strategic next steps. At the end of the day, everyone reconvened, and group leaders reported the results of their deliberations. These included the following recommendations to HRSA:

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From Controversy to Win-Win

Several years ago, the American Association of Colleges of Nursing (AACN) came to the Hartford Foundation with unsettling news. The AACN, in partnership with other nursing organizations, had developed a new, national consensus model for regulating the licensure, accreditation, certification, and education (LACE) of advanced practice registered nurses (APRNs), which would, in effect, mean the end of geriatric nurse practitioner programs as they currently exist.

The new LACE guidelines would merge the curricula and certification requirements of the previously distinct specialty of geriatric nursing with the much broader field of adult-care nursing for both clinical nurse specialists (CNSs) and nurse practitioners (NPs). Not only were those professionals who were committed to the field of geriatric nursing apprehensive, but as Rachael Watman, senior program officer at the Foundation, explains, “We were somewhat nervous that the gerontology piece would be watered down in the new curricula. We were concerned it would result in “gero-light” competencies, curricular resources, and certification exams.”

AACN was sensitive to JAHF’s concern. “Hartford had a stake in not wanting these programs to turn out nurses who were unable to provide quality care to older adult patients,” says Joan Stanley, senior director of education policy at the AACN and a co-facilitator in developing the consensus model. “To ensure that they really did provide comprehensive preparation to care for the older adult population, we came to the Hartford Foundation and suggested that we needed to create a set of consensus-based standards and competencies for these new or expanded programs in order to ensure nurses would have the knowledge and skills required in the care of older adults.”

As a result, JAHF requested that AACN submit a formal grant proposal. Hartford made the grant in 2008. The solution seemed a good one, although the transition wouldn’t be easy. For many, especially those already established in gero-nursing specialties, the new model proved difficult to accept, but unfortunately, the old way of doing things had produced disappointing results. “The Foundation had funded an effort to develop NPs in gerontology, but nationally the numbers of APRNs specializing in geriatrics were low and did not keep pace with the demographic need,” says Watman. “With the combination of adult and gero, we know that many, many more nurses will graduate with the skills to care for older adults.”

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Celebrating a Decade of Accomplishment: The 10th Anniversary of the BAGNC

This year, 2010, marks the 10th anniversary of the Building Academic Geriatric Nursing Capacity (BAGNC) initiative, and we’d like to offer our congratulations to the program’s leaders and its awardees. It has been a decade of remarkable achievement.

The Birth of an Initiative
The BAGNC Initiative began back in January 2000, when the Hartford Foundation held an invitational meeting to give experts and thought leaders an opportunity to discuss the major health care issues of older adults and to identify strategies to improve geriatric nursing care.

By the end of the meeting, two questions had emerged: (1) What were the critical issues in professional nursing that might affect the care of older adults? And (2) what challenges to improving care for older adults were most relevant and amenable to solutions by nursing schools and the Hartford Foundation? To find answers, the Foundation commissioned several papers.

This work led Hartford to formulate two top priorities that would frame a new initiative in nursing: creating centers of geriatric nursing excellence and increasing the number of gerontological nurse researchers. The Foundation’s commitment to these goals marked the birth of the BAGNC initiative.

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