Reducing Fragmentation Across Sites of Geriatric Care

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DESCRIPTION (provided by applicant): Candidate. Dr. Coleman has completed fellowships in the Robert Wood Johnson Clinical Scholars Program and Geriatric Medicine. He holds an appointment of Assistant Professor of Geriatric Medicine at the University of Colorado Health Sciences Center. The applicant's long-term goal is to develop a career as an independent investigator in patient-oriented research. His immediate goals are (a) to study care fragmentation in older patients who receive care in multiple settings; (b) obtain additional methodologic expertise with formal coursework; (c) participate in a team research environment learning all aspects of health services research in aging; and (d) participate in geriatric clinical activities. The Environment. Dr. Coleman's research office will be in the Center on Aging Research Section, which houses 18 health services researchers dedicated to the study of healthcare quality and outcomes in the older population. His sponsor is Dr. Andrew Kramer, Professor of Geriatric Medicine, and his co-sponsor is Dr. Richard Besdine, Director, Center for Gerontology and Health Care Research at Brown University. Dr. Coleman's formal research appointment with Kaiser Colorado will facilitate access to study subjects, utilization data and additional research collaborators. The Research. During an episode of illness, older patients often require care from different practitioners in multiple settings, placing them at risk for receiving fragmented care. Effective interventions are needed to reduce care fragmentation across settings of geriatric care. However, this line of inquiry is severely constrained by the absence of a validated instrument designed to measure the important attributes of care fragmentation. Our first aim is to develop and test a care fragmentation instrument. Our second aim is to test the feasibility of an intervention designed to reduce care fragmentation. Our third aim is to initiate a randomized controlled trial of this intervention. The results of this research will improve our ability to quantify care fragmentation and subsequently measure the effectiveness of a targeted intervention.