Geriatrics Clinical Teaching Services:
The medical schoolís faculty practice plan is administered by University Clinical Education and Research Associates (UCERA), as a University-associated 501(c) 3. UCERA provides the administrative support for the faculty practice plan and clinical services for all departments. Through UCERA, the medical school continues to work in collaboration with several hospitals to jointly recruit shortage specialty physicians and establish other programs. The Department of Geriatric Medicine has established several clinical teaching services for training of medical students, residents, fellows and allied health professionals.
- Teaching Nursing Home (TNH) Program: This program consists of three teaching services providing patient care in over 17 nursing homes on Oahu. The emphasis is on teaching medical care of nursing home patients, rehabilitation, palliative/end-of-life medicine, and Hospice care. Services include both primary care geriatrics and consultations. Trainees are taught principles of nursing home administration, medical directorship, and state and federal regulations governing nursing homes.
- Kuakini Medical Center Inpatient Services Program: This program includes inpatient primary care and consultations at Kuakini Medical Center. Older patients often have special medical, psychological and social needs. Trainees are taught principles of full geriatric assessment, including evaluation for common geriatric syndromes, nutritional/ elimination status, functional status, advanced directives and community referral needs. Trainees gain experience working in interdisciplinary teams, involving input from family, caregivers, nurses, medical social work, physical, occupational and speech therapy, and the referring physician.
- Alzheimerís Disease Referral Clinic (ADRC): This program offers interdisciplinary team outpatient consultations for patients with suspected memory loss or dementia.
- Parkinsonís Disease Interdisciplinary Clinic (PDIC): This program offers interdisciplinary consultations for patients with Parkinsonís Disease.
- Leahi Outpatient Geriatrics Clinic (LOGC): In 2004, the Department of Geriatric Medicine opened a new teaching clinic on the premises of Leahi Hospital near Diamond Head, a state long-term care facility. Kaimuki, the area surrounding the clinic, has a high density of older people but limited ambulatory geriatric care services. In addition to providing expert and convenient care and prevention, the clinic serves as an important new resource for training students, residents and fellows in ambulatory care. An interdisciplinary care team is available to provide comprehensive geriatrics consultations for older people who have complex medical and social problems.
- Hawaii Neighborhood Outreach to the Aged (HiNOA) Program: This new and innovative program was developed as a model for neighborhood-based elder care. It is based at Palolo Chinese Home (PCH), a non-profit multi-level long-term care facility whose board has begun a major rebuilding of its campus and the expansion of both on-site and in-home services for elders residing in the surrounding neighborhoods of Palolo Valley and Kaimuki. These neighborhoods have been professionally surveyed and have been found to contain a significant number of low and middle income elders residing in their own homes, but whose independence is threatened by frailty and by the lack of in-home services. The survey also demonstrated the paucity of physician services in the neighborhoods. Geriatricians make home visits and care home visits along with the HiNOA team, providing another site for clinical teaching.
- Hawaii Medical Center (HMC) East: A new clinical teaching program was recently developed at HMC East, to provide hospital consultations and nursing home care to elders with multiple complex problems.