THE ‘FIVE KEYS TO OLDER ADULT HEALTH’ CURRICULUM IMPROVED GERIATRIC KNOWLEDGE IN SAFETY NET PRIMARY CARE TEAMS

摘要

Background The San Francisco Health Network serves 60,000 socio-demographically disadvantaged individuals in 12 primary care clinics, all of which have growing numbers of complex older adult patients. Through San Francisco’s Geriatrics Workforce Enhancement Program, funded by Health Resources and Services Administration, we were able to partner to “geriatricize” their primary care teams through training and education. Methods We developed a geriatrics training program, the “Five Keys to Older Adult Health”, for primary care teams in the San Francisco Health Network. Almost all (n=11) primary care clinics participated in trainings from July 2015 to March 2018 on the Five Keys: Cognition, Function, Safety, Goal setting, and Mental Health. We evaluated participant’s knowledge change (1–5 scale, 5 higher) in each Key through retrospective pre-post surveys after every training. Results We delivered 62 training events to 900 trainees. Trainings were most often on-site at clinics and lecture-based and varied from weekly trainings to only one or two total sessions at that site. Trainees (n=631) were interprofessional: 27% behavioral health or social work, 20% nursing, 20% medicine, and 18% administration or social services, 16% did not specify. Trainees (n=609, 68% response rate) reported significantly (p<0.05) increased knowledge in each of the Five Keys (average change was 0.9–1.2 points increase, scale 1–5). Discussion Our results demonstrate the ability of a Five Keys curriculum to meet the urgent challenge to increase geriatrics knowledge among safety net primary care teams. Important next steps include understanding the impact of training on clinical practice change and patients’ wellbeing.