Is Geriatrics-focused Primary Care (GeriPACT) Better? A Podcast with Nicki Hastings, Kristie Hsu, and Ken Covinsky
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
46 min
4 speakers
8 chapters
transcribed 10 hours ago
Transcript
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What is GeriPACT and how does it differ from traditional VA primary care teams?
This episode of the JerryPal Podcast is CME eligible.
To claim credit, please go to the CME tab on jerrypal.org.
Welcome to the Jerry Powell Podcast. This is Eric Wadera.
This is Alex Smith. And Alex, who do we have with us today? Today we are delighted to welcome Nikki Hastings, who is a geriatrician in chief of the Division of General Medicine at Duke in the great state of North Carolina. Nikki, welcome to the Jerry Powell Podcast.
Thank you. Happy to be here.
We're delighted to welcome back Ken Kavinsky, a frequent guest and host on this podcast, who's a professor in the UCSF Division of Geriatrics. Ken, welcome back.
Good to be here,
Alex. And we're delighted to welcome Christy Shu, who is graduating from our UCSF Geriatrics Fellowship and will soon be working in a short stay rehab at the VA in San Diego. Christy, welcome to the JerryPyle podcast.
Thanks for having me.
And my son Kai is here for a little bit to help me with the guitar. He is a college student at Swarthmore, home for the summer.
So we're gonna be talking about geriatric patient aligned care teams. Do they work and who should be getting them? But before we go into that topic, we always start off with a song request. Nikki, I think you have a song request for Alex.
I do. My song request, Alex, is Carolina in my mind by James Taylor.
Why did you pick this song?
Well, it's a great tribute song to my home state of North Carolina, first and foremost. But also this song really reminds me of longing for home. That's what this song's always kind of made me feel. And actually that was a really influential concept in how we chose some of the outcomes for the study we're gonna be discussing later.
Wonderful.
Oh, here's a little bit. Love this song, thank you.
Carrin's she's a silver sun you best walk her away and watch it shinin' Watch her watch the morning come A silver tear appearing now, I'm crying, ain't I I'm gonna Carolina in my mind. And in my mind I'm gone to Carolina. Can't you see the sunshine? And can't you just feel the moonshin'? And ain't it just like a friend of mine to hit me from behind? Yes, I'm gonna carolina in my mind.
Ken, you had a critical question about that song.
Well, I I think you answered it, Nikki, but I was wonder I was wondering, is that North Carolina, South Carolina, or both? I guess it depends where James Taylor's from. North Carolina. North Carolina. Okay.
That's right. That's right.
All right, Nick, I gotta start off by asking you this question. Uh how did you get interested in this topic of outpatient geriatrics care and cherry pack teams?
Well, I got interested in the question because it's what I was doing at the time. I was seeing patients in the outpatient geriatrics clinic at RBA. And in fact I was the medical director of that clinic for about five years and I was going into the leadership of my hospital and really pitching them that we needed to grow the clinic and make it bigger. And when I did that they asked me, well How how do you know? Like how is this kind of clinic better than other kinds of clinics and what are we gonna get out of it, et cetera? And I you know, I thought I would go to the literature and answer that question and I really couldn't fully. So I said, you know, hold that thaw, I'll be back in seven years with an answer.
And went out and decided to do a research study to s really look into some of these questions.
Actually tried to figure out do they work and um If they do, kind of, how do they work and who should get it? Um I love that. Before we even dive into this topic, maybe we can just describe what a patient a geriatric patient aligned care team is or a GERIPAC team is. Can you take that?
I was gonna say, who should take that one? We could all answer that one, I'm sure. A geriatrics patient aligned care team in the VA is like a special variation of how all primary care is delivered in the VA through patient-centered medical homes. So it's a team-based care model and the geriatrics patient aligned care team was developed to be specifically for veteran older veterans with complex care needs.
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Chapters
8 chapters
1
What is GeriPACT and how does it differ from traditional VA primary care teams?
0:00–5:15
2
Why did the researchers design the GeriPACT study using target‑trial emulation methods?
5:15–10:58
3
Which patient characteristics were matched to compare GeriPACT with standard PACT?
10:58–16:58
4
What were the primary outcomes (home time) and secondary process measures evaluated in the study?
16:58–21:50
5
Why did the study find no difference in home time despite better geriatric assessments?
21:50–27:01
6
Could a longer follow‑up period or different outcome metrics reveal benefits of GeriPACT?
27:01–32:50
7
How can limited geriatrics workforce resources be best allocated in outpatient care?
32:50–38:51
8
What future research questions should be pursued to optimize geriatric primary‑care models?
38:51–46:06
Speakers
4 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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