Multi-site evaluation of an interprofessional education and systems intervention to improve geriatric screening in primary care.
5 affiliations
- 1Indiana University School of Medicine, Indianapolis, IN, USA. [email protected].
- 2Indiana University Health, Indianapolis, IN, USA. [email protected].
- 3Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA. [email protected].
- 4Indiana University School of Medicine, Indianapolis, IN, USA.
- 5Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.
Abstract
Background
To address gaps in geriatric care, the Geriatrics Workforce Enhancement Program (GWEP) implemented a multi‑year educational and systems-level intervention aligned with the Age-Friendly Health System 4Ms framework across eight diverse primary care sites. This study examined the association between the intervention and changes in geriatrics screening practices and care processes for older adult patients.Methods
In collaboration with social workers and health system educators, the GWEP team developed and implemented seven structured educational sessions for primary care teams, in addition to integrating geriatric consultants into primary care clinics and electronic medical record enhancements. Topics of the educational sessions, based on the 4Ms framework, included polypharmacy, advance care planning, and Medicare Annual Wellness Visits, with accompanying, distinct changes to workflow and care processes. Unadjusted pre-post comparisons were conducted using chi-square tests and Generalized Estimating Equation logistic regression models adjusted for covariates were used to assess screening outcomes of interest. Changes in fall risk screening rates across study phases were analyzed using a piecewise linear mixed-effects regression model.Results
Fifty-six primary care providers, along with 180 medical residents under their supervision, cared for 8,818 older adults throughout the study period. Adjusted analyses demonstrated improvements in dementia (odds ratio 1.27, 95%CI: 0.98-1.63) and fall risk screening (odds ratio 1.40, 95%CI: 1.00-1.95) following implementation of the intervention, with variability across sites and the largest gains observed in two clinics with stronger systems integration. Fall risk screening demonstrated the strongest improvement following intervention implementation (+ 0.64% per month, p < 0.001). Screening for opioid use (odds ratio 0.57, 95%CI: 0.36-0.90) and documentation of advance care planning (odds ratio 0.85, 95%CI: 0.80-0.91) significantly declined over time, coinciding with the COVID-19 pandemic. No overall significant changes were observed in hypertension control or high-risk medication measures, despite site-level variation.Conclusions
Clinics receiving additional workflow support or enhanced collaboration with geriatric consultants showed the most robust improvements. These findings highlight the importance of combining interprofessional education with team‑based infrastructure and community partnerships to strengthen geriatric care in primary care settings, while highlighting the vulnerability of complex geriatric processes during periods of healthcare disruption.
Related
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BibTeX
@article{litzelman2026multisite,
title = {{Multi-site evaluation of an interprofessional education and systems intervention to improve geriatric screening in primary care.}},
author = {Debra K Litzelman and Julie Vannerson and Emilie L Garrison and Yan Tong and Qing Tang and Melissa R Thomas and Dawn Butler},
journal = {BMC geriatrics},
year = {2026},
month = jul,
doi = {10.1186/s12877-026-08024-2},
url = {https://europepmc.org/article/MED/42907743},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Multi-site evaluation of an interprofessional education and systems intervention to improve geriatric screening in primary care.
AU - Debra K Litzelman
AU - Julie Vannerson
AU - Emilie L Garrison
AU - Yan Tong
AU - Qing Tang
AU - Melissa R Thomas
AU - Dawn Butler
PY - 2026
DA - 2026/07/01
JO - BMC geriatrics
DO - 10.1186/s12877-026-08024-2
UR - https://europepmc.org/article/MED/42907743
AB - Background To address gaps in geriatric care, the Geriatrics Workforce Enhancement Program (GWEP) implemented a multi‑year educational and systems-level intervention aligned with the Age-Friendly Health System 4Ms framework across eight diverse primary care sites. This study examined the association between the intervention and changes in geriatrics screening practices and care processes for older adult patients.Methods In collaboration with social workers and health system educators, the GWEP team developed and implemented seven structured educational sessions for primary care teams, in addition to integrating geriatric consultants into primary care clinics and electronic medical record enhancements. Topics of the educational sessions, based on the 4Ms framework, included polypharmacy, advance care planning, and Medicare Annual Wellness Visits, with accompanying, distinct changes to workflow and care processes. Unadjusted pre-post comparisons were conducted using chi-square tests and Generalized Estimating Equation logistic regression models adjusted for covariates were used to assess screening outcomes of interest. Changes in fall risk screening rates across study phases were analyzed using a piecewise linear mixed-effects regression model.Results Fifty-six primary care providers, along with 180 medical residents under their supervision, cared for 8,818 older adults throughout the study period. Adjusted analyses demonstrated improvements in dementia (odds ratio 1.27, 95%CI: 0.98-1.63) and fall risk screening (odds ratio 1.40, 95%CI: 1.00-1.95) following implementation of the intervention, with variability across sites and the largest gains observed in two clinics with stronger systems integration. Fall risk screening demonstrated the strongest improvement following intervention implementation (+ 0.64% per month, p < 0.001). Screening for opioid use (odds ratio 0.57, 95%CI: 0.36-0.90) and documentation of advance care planning (odds ratio 0.85, 95%CI: 0.80-0.91) significantly declined over time, coinciding with the COVID-19 pandemic. No overall significant changes were observed in hypertension control or high-risk medication measures, despite site-level variation.Conclusions Clinics receiving additional workflow support or enhanced collaboration with geriatric consultants showed the most robust improvements. These findings highlight the importance of combining interprofessional education with team‑based infrastructure and community partnerships to strengthen geriatric care in primary care settings, while highlighting the vulnerability of complex geriatric processes during periods of healthcare disruption.
SN - 1471-2318
ER -