THE NEW GERIATRIC INTERPROFESSIONAL TEAM TRANSFORMATION IN PRIMARY CARE: AN IMPLEMENTATION SCIENCE APPROACH

Abstract

The Dartmouth Centers for Health and Aging Health Resources and Services Administration (HRSA) Geriatric Workforce Enhancement Program (GWEP) led an implementation program focusing on transforming primary care around best geriatric practice. In addition to improving patient outcomes, the objective was to increase practice efficiency and revenue. We expanded upon the original Geriatric Interdisciplinary Team Training (GITT,) developed in the 1990’s with support from the John A. Hartford Foundation, and developed the Geriatric Interprofessional Team Transformation in Primary Care (GITT-PC) model. The focus of the model is to create practice change by leveraging Medicare reimbursement through the following billable codes: Annual Wellness Visit (AWV), Chronic Care Management (CCM), Advance Care Planning (ACP), and Dementia Codes. The implementation included face to face in-person trainings focusing on Team Training “Teaming Up”, “Quality Improvement 101” and 4 training and implementation bootcamps around each of the four Medicare codes. The success of this model is tied to the implementation strategy. This program will provide an overview of the implementation and adaptation of the model including a comparison of two strategies: (1) on-site elbow to elbow coaching and (2) virtual learning collaborative approach. An equal variance t-test was conducted to compare the number of AWVs billed during the intervention period by the on-site coaching practices (M=27.22, SD=3.49) and learning collaborative practices (M=120.44, SD=25.72); t(16) = -10.773, p<0.05. These early results show that the learning collaborative group outperformed the on-site coaching group. This program will discuss the secret sauce and the science of implementing the GITT-PC model.