I. Mission and Vision
Mission: Improve the health and health care of all older adults through research, education, and clinical care that recognizes and respects differences in individuals’ health conditions, health priorities, and life circumstances.
Vision: All older adults will receive health care that is informed by gerontologic discoveries and provided by health professionals skilled in geriatric principles.
II. Strategic Initiatives
a. Center for Person-Centered Decision Making for Vulnerable Older Patients
b. Center for Aging with Intellectual and Developmental Disorders
c. Population Data Sciences and Aging
III. Center for Person-Centered Decision Making
a. Background: Vulnerable older patients do not always benefit from traditional approaches to the management of chronic illness. They may be less likely to obtain benefit and more likely to suffer adverse effects of routine care. Therefore, a greater range of treatment options need to be considered, in the context of their goals and values. The goal of the center to is develop the methods and deliver the care to provide older persons with treatment options that are most likely to achieve for patients the outcomes that matter the most.
b. Partners: Cardiologists, oncologists, endocrinologists who are asking for geriatric input on management decisions.
i. Clinical: establish new clinical models of co-management of a range of chronic diseases, with the geriatrician providing a framework for decision making
ii. Educational: establish curriculum to teach medical students and internal medicine residents about personalizing care for older patients.
iii. Research: create cores of expertise in decision making, communication, health services to promote the development and dissemination of new approaches to decision making.
d. What Success Looks Like:
i. New research center (P30 grant) bringing together investigators from geriatrics, internal medicine and its subspecialties, cognitive psychology, health communication.
ii. New co-management clinics with clinical partners
iii. Clinician-educator with a focus on curriculum development
IV. Center for Aging with Developmental and Intellectual Disabilities
a. Background: As adults are living longer with developmental and intellectual disabilities, there are few providers who understand how to manage these disabilities with the comorbidities and added vulnerabilities associated with aging.
b. Partners: Department of Developmental Services and Department of Aging, State of Connecticut; Yale New Haven Health System; Law School
i. Clinical: establish a dedicated clinical service for evaluation and management of this patient population
ii. Educational and research: new curriculum, potentially unique cohort for outcomes research
d. What Success Looks Like
i. Hospital support for clinical services
ii. Demonstration of ability to advance knowledge from clinical population.
V. Population Data Sciences and Aging
a. Background: There is growing interest in the use of “big data” to improve the health of populations. A critical limitation in geriatrics is that key data elements for defining the health of older persons are missing from most data sets. The most prominent missing data elements are measures of function and cognition.
b. Partners: New data science initiative at the School of Medicine, informatics, and population health colleagues in the health system
i. Establish methods for routine collection of function and cognition measures for older persons in the health system in a uniform manner across all sites and clinical services.
ii. Disseminate the use of these measures by demonstrating their utility.
iii. “Phenotype” the older population in terms of function and multimorbidity.
d. What Success Looks Like:
i. Data elements in Epic for measurement of physical and cognitive function.
ii. Use of these elements with routine data collection.
VI. Additional Considerations
a. If you build it, they will come: We would like to start work on these in whatever ways we can, given our limited work force. If we can advertise these efforts, we hope to increase interest and enhance recruitment.