Geriatric Research Education and Clinical Center (GRECC)

Tennessee Valley GRECC

• Cognitive impairment
• Quality and safety of care
• Chronic disease prevention and management

• Critical illness, including COVID-19, associated cognitive impairment and long-term cognitive impairment: prevention, diagnosis, and treatment for patients and caregivers
• Depression and cognitive impairment in older adults: mechanisms of disease, prevention and treatment
• Quality and outcomes of emergency care for older adults
• Surgical quality and outcomes in older adults
• Hypertension, heart failure, cardiovascular disease and diabetes prevention and management
• Congestive heart failure diagnosis and management in older adults
• Lung cancer prevention and screening
• Prediction modeling and clinical decision support
• Medication risks, utilization, and management in older adults

• GERI-A-FLOAT: Developed GERIAtrics Fellows Learning Online And Together (GERI-A-FLOAT), an educational series that uses virtual meetings to deepen knowledge of geriatric medicine and to convene fellows from across the country for networking and peer support
• The Middle TN Geriatric Workforce Enhancement Program (GWEP) includes TVHS and 12 community and academic partners; addresses Tennessee’s health rankings and health profession shortfall by integrating geriatrics into primary care delivery systems while increasing the pool of quality geriatric providers
• Geriatrics Grand Rounds, Annual Geriatrics Update Conference, Geriatrics Interprofessional Training Programs and Geriatric Medicine and Advanced Geriatrics Fellowship Programs
• Palliative Scholars Program to enhance competencies of providers in the care of the elderly rural Veteran with life limiting advanced illnesses
• Flipping the Acute Care for the Elderly Teaching Sessions (FACETS™): an innovative, competency-based curriculum for internal medicine residents
• Geriatric Scholars Program quality improvement curriculum: to train interprofessional providers in quality improvement
• Tool kits for clinicians to improve palliative care and management of COVID-19 within the hospital and long-term care settings
• Host global website for critical illness and COVID-19 related cognitive impairment management for clinicians, patients and families
• Health services research, implementation science and quality improvement training programs, including the VA Quality Scholars Program

• Supported implementation of our GRECC developed ICU measurement instruments into VA clinical systems across VHA
• Our ICU bundle has become the global standard of ICU care but following pandemic, global adherence slipped; we are planning re-implementation strategy
• Demonstrated a substantial reduction in mortality with the use of baricitinib among critically ill patients with COVID-19, which has now become the global standard of care
• Collaborating with the TN Department of Health to assess ongoing COVID-19 needs in 75 Middle Tennessee nursing homes to develop individualized staff coaching interventions
• Reaching out to underserved and rural caregivers and Veterans with advanced serious illness utilizing video connect, video-telehealth visits and e-consults
• Tele-PT for Falls Prevention, a new GRECC interprofessional program designed to combine falls consultation and telehealth to reduce falls for Veterans referred for falls risk
• Embedding palliative care into oncology clinics
• Shed-Meds is a program to identify and eliminate unnecessary medications among older Veterans to reduce medication associated effects

• Primary Occurrence of Cardiovascular Events After Adding Sodium-Glucose Cotransporter-2 Inhibitors or Glucagon-like Peptide-1 Receptor Agonists Compared With Dipeptidyl Peptidase-4 Inhibitors: A Cohort Study in Veterans With Diabetes  Ann Intern Med. https://pubmed.ncbi.nlm.nih.gov/37155984/
• Deprescribing Medications Among Older Adults From End of Hospitalization Through Postacute Care: A Shed-MEDS Randomized Clinical Trial  JAMA Intern Med. https://pubmed.ncbi.nlm.nih.gov/36745422/
• Association of Vitamin C, Thiamine, and Hydrocortisone Infusion With Long-term Cognitive, Psychological, and Functional Outcomes in Sepsis Survivors: A Secondary Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis Randomized Clinical Trial. JAMA Netw Open https://pubmed.ncbi.nlm.nih.gov/36853612/
• Cognitive, Disability, and Treatment Outcome Implications of Symptom-Based Phenotyping in Late-Life Depression  Am J Geriatr Psychiatry. https://pubmed.ncbi.nlm.nih.gov/37385899/

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