15th Annual 2012 NICHE Conference:
Improving Health Care of Older Adults: Continuing the Journey
These protocols served as the basis for the Geriatric Institutional Assessment Profile (GIAP), an instrument designed to help hospitals analyze the needs of their older adult patients and determine gaps in geriatric care provision. Click here to read more about the GIAP. NICHE staff convened four workshops linked to national professional nursing meetings to solicit proposals from hospitals to participate in the implementation and evaluation of NICHE activities. Twenty-three hospitals applied to participate. Four sites were selected to field-test the NICHE tools and processes. These sites were: The University of Virginia, Charlottesville, Virginia; North Iowa Mercy Health Center, Mason City, Iowa; University of California, Davis Medical Center, Sacramento, California; and Methodist Hospital Of Indiana, Inc., Indianapolis, Indiana.
An evaluation documented improvements by surveying staff before and during the implementation of NICHE regarding their perceptions of geriatric care and using quality assurance, risk management, and human resources allocation data from the four NICHE sites.
The following organizations joined the original four field-test sites: Bassett Health Care, Baystate Medical Center, Charleston Area Medical Center, Barnes Jewish-Christian Health System, and New Rochelle Hospital Medical Center.
The findings from field tests resulted in the NICHE Tool Kit that includes the following:
- The NICHE Planning and Implementation Guide
- Effective nursing care models, including the Geriatric Resource Nurse (GRN) model and the ACE (Acute Care for Elders) models.
- Revised Geriatric Institutional Assessment Profile (GIAP)
- Expanded clinical practice protocols that reflect the standards of nursing practice on 13 important geriatric syndromes
Since 1996, NICHE has been an integral program of the Hartford Institute for Geriatric Nursing, physically relocating to the Hartford Institute site in 1999. Among the many accomplishments during this period include expansion of the NICHE Tool Kit and NICHE Resources. Examples include:
- An Annual Conference in New York City
- Revised Clinical Practice Protocols
- Best Nursing Practices in Care for Older Adults Curriculum Guide available on CD-ROM
- Sample course outlines in geriatric
- Geriatric nurse competencies for use by staff nurses, managers, and staff developers
- The Gerontological Nursing Certification Review Course
- National listserv for NICHE sites to share resources and information
NICHE has grown to include a national network of hospitals that share lessons learned, and collaborate to inform the further development of resources at the NYU College of Nursing.
In 2003 NICHE was expanded with three new initiatives…
- Geriatric advanced practice nurse leads practice initiatives of the Hartford Institute
- GIAP Benchmarking Service moved to New York University
- GIAP Research Group was organized to develop research initiatives
In 2007 Atlantic Philanthropies (U.S. Aging Programme) funds the 5-year business plan to help NICHE build its internal capacity, dramatically improve the program's "toolkit," and accelerate adoption of the program by more hospitals. NICHE has made tremendous progress in assembling a core of internal staff in order to build and support a sustainable model of growth.
In 2008 and 2009 NICHE launched a robust website to facilitate peer-to-peer exchange and a community of learning. NICHE launched several web-based training and education tools hosted on a members only website.
In 2009 NICHE introduced the online Leadership Training Program to increase the flexibility and affordability of starting a NICHE program.
In 2009 NICHE launched the NICHE Knowledge Center, which houses the 6-week online Leadership Training Program, online courses, interactive webinars, and other resources. The Knowledge Center seeks to further enhance the dissemination of knowledge and provides flexible, on-demand access to NICHE resources.
NICHE reaches a milestone 300 hospitals in its North American network, sustaining and building on its position as the leader in delivering evidence-based best practices and tools for improving care of older adults. Over 450 health care providers representing over 175 hospitals attended the 2011 NICHE Conference — largest conference ever!
The 78-million member baby boom generation born between 1946 and 1964 began turning 65 in 2011. And the number of people age 65 and older is expected to grow from 39 million in 2008 to 72 million in 2030. This explosive growth will place great demands on our healthcare system. NICHE is well positioned to help healthcare professionals rise to the challenge for the older adult.
NICHE continues today to build the capacity necessary to ensure the right resources, tools and models are available to help improve the quality of health and quality of life of older adults across the spectrum. Growing NICHE means building leadership and capabilities to enact system level change and paradigm shifts that target the unique needs of older adults.
