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Geriatric Research Education and Clinical Center (GRECC)

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Cleveland GRECC

The Cleveland GRECC has been serving older Veterans in the Ohio area since 1999.

 Research Focus Areas

         Infections in the Elderly specific to Urinary Tract Infections
Clostridium difficile (C-Diff)
     Influenza in the Elderly
            Dementia specific to HIV and Case Management
                 Catheter Associated Urinary Tract Infection (CAUTI)
                        Chronic Viral Infections in the Elderly
     Immunology of Aging
      Antibiotic Stewardship
Antibiotic Resistance in the Community Living Center (CLC) 
                  Congestive Heart Failure and Aging
                       Delirium Recognition and Management
         Falls Prevention

Research

The Cleveland GRECC is dedicated to addressing the challenges of infections and promoting better health in the older adult. Our research goals are integrated into a program of biomedical and clinical research to increase our understanding of immunological responses. Our research focus includes infections, HIV, Hepatitis C, Varicella Zoster, vaccinations, antibiotic resistance, Clostridium difficile (C. diff.) and catheter associated infections. In addition, our studies include delirium recognition and management, falls prevention, congestive heart failure and aging, immunology of aging, and dementia specific to HIV and case management. 

Education and Evaluation

The Cleveland GRECC coordinates a weekly continuing medical education series for healthcare professionals "Topics in Geriatric Medicine" which is televideoconferenced throughout Northeast Ohio, North Carolina, New Hampshire and West Virginia.  A yearly roundtable: Vaccinations in the Older Adult, is designed to improve optimal vaccination levels, improve vaccination coverage for influenza, pneumococcal disease, shingles and Hepatitis A & B.  This effort is the first of a multi-phase approach for healthcare providers to improve vaccination rates among older Veterans.  Six online training modules for nurses to improve the care of older Veterans with infections are asymptomatic bacteria vs. urinary tract infections, respiratory tract infections, isolation precautions, collecting samples for microbiological culture & available through the VA's online training program.  These modules focus on signs & symptoms of infections in older adults, communication using Situation, Background, Assessment, Recommendation (SBAR) technique. We also implemented a multi-educational program utilizing webinars, videos, case studies, pocket cards, simulation training and bedside mentoring by our delirium resource team. 

Clinical

The GRECC operates an Infectious Disease on-site consultation program in the Community Living Center (CLC) and has expanded to the Chillicothe VA Medical Center.  This program continues to improve on the use of antimicrobials.  Our GRECC provides early transitional care (BRIDGE) to home for a group of older hospitalized Veterans who meet specific criteria including polypharmacy, cognitive and social issues.  Our specialized Home Based Primary Care (HBPC) teams makes early contact and home visits soon after discharge to assess medication reconciliation/adherence, caregiver and physical assessment and cognitive screening.  We have also implemented a geriatric preoperative optimization program designed to reduce geriatric post-operative complications by enhancing identification and treatment/prevention of cognitive mood, medication, social support issues and functional problems. 

Cleveland GRECC Profile

Louis Stokes Cleveland VA Medical Center
10701 East Boulevard
Cleveland, Ohio 44106

Affiliation
Case Western Reserve University

GRECC Director
Robert A. Bonomo, MD

Associate Director, Research
David Canaday, MD

Associate Director, Education & Evaluation
Denise M. Kresevic, RN, PhD

Associate Director, Clinical
Thomas Hornick, MD

Administrative Officer
Malva Rashid