Hearst Foundations Award $600,000 to Support
Chief Resident Training in the Care of Older Adults

The Association of Directors of Geriatric Academic Programs and Boston
Medical Center Partner on a National Dissemination of an Innovative Educational
Program to Improve Geriatric Care

The Association of Directors of Geriatric Academic Programs (ADGAP) in partnership with Boston Medical Center (BMC) has been awarded a $600,000 grant from the Hearst Foundations, to support a program entitled Chief Resident Immersion Training in the Care of Older Adults (CRIT).  The CRIT program familiarizes chief residents with health problems common among older adults, the assessment of older patients, preoperative and postoperative evaluation, and management and discharge planning.  This is the first year of a potential 4-year $2.2 million project that will be evaluated annually, with the possibility of renewed funding.  

The four schools that were selected to participate in the CRIT program this year include Northeast Ohio Medical University, Stony Brook School of Medicine, University of Arizona College of Medicine and Warren Alpert School of Medicine of Brown University.    

The CRIT program addresses a critical yet largely unmet need in our country – to ensure that all physicians receive training in the care of medically complex older adults, who make up the fastest growing segment of our population.  The CRIT program: 1) provides geriatrics training to Chief Residents in a variety of medical and surgical specialties through intensive educational retreats and mentored year-long projects, 2) fosters institutional collaboration across specialties and healthcare disciplines to improve the coordination and quality of care for hospitalized older adults, and 3) enhances the teaching and leadership skills of Chief Residents.  Chief Residents are the target group for this educational intervention because they play key teaching, patient care, and communications roles in their hospitals.

The CRIT program is based on a train-the-trainer model.  Senior faculty from medical centers, selected through a peer-reviewed application process, attend an annual Chief Resident geriatrics training retreat held by BMC, to learn how to plan and facilitate CRIT retreats at their own institutions.  Then, with a grant issued to each participating institution, these senior faculty and their CRIT project teams conduct CRIT retreats for their incoming Chief Residents.  After the retreat, participating Chief Residents, under the guidance of faculty mentors, develop and implement year-long patient care or education projects designed to improve the care of older patients at their hospitals.  

Sharon A. Levine, MD, Associate Dean for Academic Affairs at Boston University School of Medicine and developer and current director of the CRIT program, first designed CRIT in 2003 with support from the Donald W. Reynolds Foundation.  In 2007, BMC was awarded funding from the John A. Hartford Foundation in collaboration with ADGAP to support a CRIT national demonstration project.  The newest Hearst Foundations grant will provide for the dissemination of CRIT to up to another 19 institutions around the country.

“It is in the best interests of all older adults, our communities, and Medicare to ensure that all physicians receive sufficient training in how to manage medically complex older adults, and how to work collaboratively among and across specialties to improve hospital care quality and safety for older people,” said Dr. Levine. 

“The CRIT program is a proven approach to addressing this pressing need.  We greatly appreciate the support of the Hearst Foundations in bringing this program to more institutions around the country.”

Paul Dinovitz, Executive Director of the Hearst Foundations said, “We are delighted to be partnering with ADGAP and BMC to bring the Chief Resident Immersion Training program to more institutions.  We are proud to see Chief Residents and faculty members alike broaden and deepen their medical acumen because of this program.  The CRIT program’s brilliance is in targeting our youngest and most energetic physicians, across a range of disciplines, and imbuing them with the nuances of caring for complex older adults.  We hope these young doctors will share our sense of urgency on the need to improve care for this growing portion of our population.”

To date, the CRIT program has been conducted 44 times at 16 institutions nationwide.  A total of 675 Chief Residents and 205 faculty representing 29 medical and surgical specialties have been trained.  The CRIT program is part of the Hearst Foundations new Aging Initiative that is supporting three major training programs in geriatric medicine and nursing, and hospice and palliative medicine.