(upbeat music)
- We are so glad to be here today.
I'm Alison Moore,
and I'm Chief of Geriatrics and Gerontology
in the Department of Medicine at UC San Diego.
- Hi, I'm Khai Nguyen Clinical Services Chief,
here at the Division of Geriatrics and Gerontology.
Thank you for having us.
- This is our group here at our retreat last January.
So Khai, did you imagine that we'd be here today
in 2020, ranked 13th in the nation when we got here in 2016?
- You know Alison, this is quite an opportunity
for us here to be 13th in the nation now,
considering where we were at.
So I'm very excited about this opportunity for us
and certainly this is a wonderful dream.
- Yeah, fantastic, so today we'll be talking
with you about our mission and our vision.
And we'll be sharing with you some details
about our clinical care, our teaching, and our research,
and about what we've accomplished
and what we hope to accomplish.
To recap our mission as stated on the slide here is,
to optimize the experience of aging through excellence
in clinical care, inspired teaching
and transformative research.
And our vision is to create a better world for aging people.
So we're gonna start with clinical care.
- Thank you, Alison.
So I'm gonna talk about our clinical excellence
here at UC San Diego,
and really about Age Friendly Care.
So we are excited to talk to you about our journey
to number 13, and as a part of that work,
our journey with Age Friendly Health Systems.
We are considered early adopters
in this movement nationally,
and among that work,
we have become part of a national initiative
to improve senior care.
And we are the first health system in San Diego
to join Age Friendly Health Systems,
and to also be recognized
by the Institute for Healthcare Improvement,
as committed to care excellence.
As a part of that work,
we are able to work very closely with our leadership
to create the first,
Inaugural Geriatrics Quality Medical Director,
who is Dr. Lindsey Yourman.
As part of that work,
it's to improve Age Friendly Care
across the continuum here at UC San Diego Health.
And that builds upon our programs
that currently already exist,
as we are niche designated hospital in exemplar status.
As part of Age Friendly Health Systems,
the focus is on the forums framework.
To briefly describe that to you,
it's a focus on what matters to patients,
with goal concordant care
with what they would like with their health.
But also to focus on mentation,
particularly with dementia, coexisting depression,
and also delirium that can sometimes be seen
in the hospital.
But it's not only there,
it's also focused on medications, regarding our seniors
and also focus on mobility,
to keep our seniors functional.
So these are all the wonderful opportunities
that we have to offer with Age Friendly Health Systems.
As part of the Age Friendly Health System work,
we have an array of services that we provide here
for senior care among our geriatric clinical service lines.
Particularly, there are a lot of new programs,
such as the Senior Emergency Care Unit,
that is primarily run by the Emergency Medicine Department
with their work with the West Health Institute.
But also newer programs such as,
the Inpatient Trauma Consult service,
our work with the neuroscientists
in general psychiatry departments
for the Center for Brain Health and Memory Disorders
to take care of patients with dementia
and to have continuity,
but also with population health,
where there is wraparound services for our senior members
and also providing home based care
and care even at skilled nursing facilities.
But not to forget some of our foundational programs
that have existed for a very long time,
which is Senior Behavioral Health,
which is the only Gero psychiatric unit of its kind
in Southern California.
But also for our foundation of our care,
which is our Outpatient Geriatric Services,
which is medicine for seniors.
So I would like to talk about future clinical initiatives,
which we hope
to continue building upon our age friendly programs.
And that also means
to build upon interdisciplinary infrastructure.
As part of that as you could see here,
mentioned is that 'You're Only Old Ones' book
by Dr. Seuss that he wrote in 1989,
which it turns out is a memoir
of his experiences receiving care that was not age friendly.
And we hope in his honor
to be creating a new clinic space for medicine for seniors
and imagining what
that care could be like under Age Friendly Care,
which is incorporating the four M's discussed
in the previous slide.
As part of that, we hope to build a true,
a team based approach
where we have social workers, nurse practitioners,
pharmacists also helping our seniors,
also to provide an environment, where seniors are welcome.
We've gotten permission from the Dr. Seuss Enterprises
and are currently working with the Dr. Seuss Foundation
to secure funding, to be able to paint a space,
to be able to mural the images
of the 'You're Only Old Once' book into this future medicine
for seniors clinical space.
The hope is that, that will inspire wonderful
and age friendly care for our seniors,
and also provide a welcoming environment
in only a way that Dr. Seuss can provide.
As part of building upon the Age Friendly Programs,
we hope to continue having geriatricians embedded
in clinical teams,
also even models of care such as,
the Acute Care for the Elderly,
which is a unit in hospitals
and also programs such as,
the Orthopedics Co-management Care
and also the geriatric services verification
that essentially embeds geriatric principles
and geriatricians within clinical teams.
- Thank you Khai.
All right, now we'll move on to our teaching program.
So we call that inspired teaching
and our aim is to increase geriatrics expertise.
Geriatricians are rare individuals
in comparison to the large number
of older adults in the US close to 50 million.
They're only 2 or then 7,000 geriatricians,
versus 200,000 primary care physicians or P-C-Ps.
So our goal is to do the best we possibly can
to train as many geriatricians as we can,
and to train as many others as we can
to understand the needs of older adults.
So to that end,
we have a geriatrics fellowship that's based at both U-C-S-D
and the V-A,
and we train up to three fellows each year.
That's a picture of our three fellows from last year.
We, in addition, have they brand new coming up this year,
Geriatrics Quality Improvement Fellowship co-funded
with the West health Institute and led by Dr Lindsey Yourman
who you saw a name of earlier.
And we'd like to,
as a future goal have a sustained commitment
to funding for our fellowship programs
'cause each year it's a little iffy.
Second, we have residency training
that has been done in San Diego also for quite some time.
We train not only our internal medicine residents,
family medicine residents, and pharmacy residents
at UC San Diego,
we also train residents from other programs in the city
like Family Health Centers Scripts and Camp Pendleton.
So we've done we do a lot of residency training,
but we'd like to do more.
And we'd like
to offer more experiential educational programs
for them novel educational programs for them.
We train medical students too.
So we have a student interest group
that's been active for a number of years
and through the generosity of Dr. Ruth Coville,
former member of our faculty and the geriatrician,
she provides an award each year
to a graduating medical student
who is interested in geriatrics.
And so that's also a support for our program.
And we have elective rotations
in both the third and fourth years medical school
for students to get more education in geriatrics.
We of course like to offer additional training programs
for students, including launch partnerships
with older adults so that the students get
to know an older adult over time,
and get to know how all the wonderful aspects
of being an older person
like we do.
We also want to increase gerontology expertise
that is, the study of aging.
So to that end,
and also clinical aging Dion's doctoring.
So we have this incredible program called,
the San Diego Imperial Geriatric Education Center.
This is in partnership with San Diego State University,
and it's funded
by the Health Resource and Services Administration.
This is a program
that in San Diego and Imperial Counties,
educates the workforce.
So a whole variety of disciplines,
social work, nursing, physicians, physician assistants,
and it educates them to understand the needs
of aging people including the focus on people with dementia.
We also do a lot of research training here,
primarily funded by the National Institute on Aging.
There's been a longstanding program called MSTAR,
and that's been led by Dylab Justin for many years.
In this last year,
I had the privilege to join him in this effort.
There's also a brand new training program called the T32
that is focused on aging led by Andrea LaCroix here
in the Department of Family Medicine and Public Health,
soon to be School of Public health,
already School of Public Health
that trains postdocs as well as junior faculty
in aging science.
And finally, we have since I came anyway,
end Monthly Geriatrics and Gerontology Grand Rounds,
that's open to the community
where we share various topics
in Aging Science Education and Clinical Care.
So for all these programs
for you of course, we'd love funding
for interdisciplinary training.
We'd love to do more in the community
to educate them about all these topics
and to learn from them.
Last on the mission areas is research.
So Transformative Research in Aging.
So I came here courtesy of the Larry L. Hillblom chair
in Geriatric Medicine
that really enabled me to focus on building this program.
And I can tell you sort of every other thing
in research is because of my being able to have that time
'cause when I came, there was pretty much not anything.
So one of the new things
that we have is this Gerontology Research Collaborative.
I was able to recruit Dr. Anthony Molina,
who's a gerontologist from Lake Forest University.
And with this collaborative where you have monthly seminars
with aging scientists across the multiple institutions
in San Diego, who do aging science,
Salk and Sanford Burnham,
San Diego state, that's been a terrific opportunity.
We also have been able to recruit other aging scientists
in our division and have others
from other entities joined us to do aging science here.
So we study a variety of topics listed there.
So it's typical for aging scientists
to study a variety of things
because of the heterogeneity of aging.
And so that's sort of part for the course.
We've also been able to get a number of centers funded.
So the two that we have in hand thus far
and this is not easy to do, I gotta tell you,
so I'm very proud of this are,
the Alzheimer's Disease Resource Center
for Minority Aging Research.
This is funded by the National Institute on Aging.
This is in partnership with S-D-S-U
and it's goal is
to fund underrepresented investigators
from racial and ethnic minority backgrounds
to do research on Alzheimer's disease.
And we we're in year three of that center.
And we also just recently got we received
in partnership with Salk and S-B-P Research Institutes,
and Nathan Shock Center of Excellence
in the Basic Biology of Aging,
another N-I-A funded International Institute
of aging funded center.
That's we are a partner site with them
and that it's courtesy again of Anthony Molina being here.
He does translational research
so the Basic Biologists and Salk
and Sanford Burnham give him their specimens
and he's gonna develop a cohort also of the people
that they wanna do their research with him.
And progress, I've been leading this effort here
to get another center.
It's a Cloude D. Pepper Older Americans Independence Center.
The goals of this center is to focus on technology,
to serve older adults, to maintain independence.
So in this effort I've been partnering
with many fantastic engineers here
and data scientists and informaticist
and ethicist to put together this center
that has this focus.
And then other future endeavors,
we have our many and some of these are listed here.
We'd like to have,
a Geriatric Science Mobile Research Initiative,
which will be a community deployed platform
to understand mechanisms that underlie aging
and test interventions
to either ameliorate some of the negative aspects of aging
and enhance the positive aspects of aging in the community,
a place where too little research occurs.
We'd also like to develop a Center for Diversity and Aging.
We do have that Resource Center
for Minority Aging focused on Alzheimer's disease.
We'd like to have more work done in Alzheimer's topics
and include more people.
And then as always,
we'd like to have sustained funding
for faculty, more chairs.
I came here because of this chair,
we'd like to have more chairs
to be enabled more faculty to be able to focus on research
and focus on their being able
to do more program building like I've been able to do here.
So in conclusion,
Khai, you wanna take it away here?
- Absolutely, so this is quite a journey for us
to be 13th in the nation
and to really to be able to accomplish our goals,
to optimize the aging experience,
provide excellence in clinical care, in inspired teaching,
but also transformative research.
So we thank everyone for your time.
And again, thank you.
(piano music)