Message from our Division Director: Stefan Gravenstein, MD

Geriatrics and palliative care share a common goal of improving lives through better care in populations in whom quality of life, frailty and independence are threatened. Our faculty teach and study to achieve this goal. The daily task of transforming care from what people are getting to what people want (and need) motivates our care, teaching, and science. Both palliative and geriatrics themes permeate our work and beckon other specialists, scientists and learners to our Mission. We invite you to ask us about how we elevate palliative and geriatrics care clinically and scientifically.

Mission

Through collaborative care, education and science, we aim to improve the quality of life and well-being of all older adults.

About Us

Our Division serves as the base for all academic activities in Geriatrics and in Hospice/Palliative Medicine (HPM), including the Geriatric Medicine Fellowship Program and the HPM Fellowship Program. We anchor our program at Rhode Island Hospital and The Miriam Hospital in Providence, Rhode Island, but our education and research programs span four entities: Brown University Health, the Providence Veterans Administration Medical Center (VAMC), Care New England, and Brown University.

Our diverse clinical faculty offer expertise in clinical geriatric and palliative medicine, and include 15 geriatric medicine, 17 palliative medicine, 3 neurology, and 4 geriatric psychiatry physicians, and 5 geriatric nurse practitioners. The Brown University School of Public Health’s center and the VAMC’s Center on Innovations in Long Term Services and Supports (COIN-LTSS) provide the major research resource for clinical fellows and faculty. Our collaboration produces prominent health services research on aging and chronic disease, especially long-term care. Three dozen full-time research faculty serve as mentors, collaborators and advisors across multiple disciplines. The Geriatric Medicine and HPM Fellowships link Brown and the Division with multiple clinical sites and faculty preceptors, with the aim to generate new academic geriatricians for faculty positions nationwide.

Many of current Division research activities are in collaboration with the Brown Public Health School’s Center for Gerontology and Health Care Research (CGHCR). The CGHCR is one of 14 research centers of the Brown School of Public Health and is the major clinical research resource on aging at Brown. The Center is strongest in health services research on aging and chronic disease, especially long-term care; recently, Pragmatic Trials have also become a major part of the portfolio. Thirty full-time investigators and more than 20 staff are based in the Center. External funding exceeded $18 million last year. Research on the basic biology of aging is also very strong on the Brown campus. Five senior faculty members conduct research on the molecular biology and genetics of aging and longevity; extensive NIH and NSF funding is in place. A T32 post-doctoral training grant has been funded.

Research themes and project areas for the Center and the Division include:

• Primary and secondary prevention of disease and its functional consequences: Screening, service use, preventive services.
• Innovation in chronic disease management and care systems: Pharmaco-epidemiology, end-of-life care, cancer care.
• Measurement and improvement of quality in long term care: Nursing homes, hospitals, hospice, community-based care.
• Organizational factors associated with the distribution and quality of health care services for older adults: Effects on service use, quality of care and clinical decision-making.
• Disparities by race and ethnicity in quality of health care outcomes.

Abundant research projects and opportunities thrive at our Providence VAMC affiliate. In conjunction with faculty with the Division of Geriatrics & Palliative Medicine and CGHCR, the Providence VA has developed a robust research program in aging with over $1.5 million in VA funding annually.

Opportunities include:

• One of only 19 Center of Innovation (COIN) program grants, dedicated exclusively to long-term care delivery within the VA
• An HSR&D Collaborative Research to Enhance and Advance Transformation and Excellence (CREATE) Initiative dedicated to innovative approaches to long term care delivery.
• A nationally recognized Antibiotic Stewardship Program in collaboration with the School of Pharmacy at the University of Rhode Island.
• Additional funding related to rehabilitation services, congestive heart failure, homelessness research, pain management, and addiction medicine.

Research Facilities

• Center for Gerontology and Health Care Research
• Collaborations also occur with Healthcentric Advisors, the quality improvement organization for the State of RI. Healthcentric Advisors currently holds the quality improvement contract for Medicare beneficiaries in RI.