Fall 2015
Sanford Center Geriatric Specialty Clinic Opens

synapse: University of Nevada, Reno School of Medicine

Sanford Center for Aging staff.

Leaders Create Resource for Older Adults: Peter Reed, Sanford Center director; Kelley Macmillan, social services director and Steve Phillips, medical director form the leadership team for the new clinic. Photo by Anne McMillin.

Story by Anne Pershing

The new Sanford Center Geriatric Specialty Clinic will offer older adults across northern Nevada a new resource for clinical services and support promoting the quality of life.

Peter Reed, Ph.D., MPH, director of the Sanford Center for Aging, explained that the vision for the clinic honors the legacy of Jean Sanford: all older adults in northern Nevada will have access to comprehensive geriatric specialty services to complement the primary care they already receive.

The geriatric clinical services will use a whole-person, interdisciplinary approach to care to promote the well-being of each individual.

The new model begins with a comprehensive, three-hour individualized assessment, including a wellness visit, exploring all aspects of health. Services include physical, psychosocial, spiritual, advanced care planning and a comprehensive medication management review. A team of aging specialists will provide the assessments in concert with the older client and his/her care partner(s) in order to ensure that the aspects of life that are important to the client will be included in the client's care and support plan. This assessment will be communicated to the client's primary care provider with recommendations for support and service referrals.

After initial assessment, the Sanford staff will meet with the client and care partner to determine a care coordination program that will connect the client with the resources they need to maintain independence and optimize relevant health outcomes.

The care coordination process also will include ongoing chronic care management of those clients with three or more of the 27 chronic conditions designated by the Centers for Medicare and Medicaid Services. This comprehensive approach to care coordination can include referrals for additional services, arranging transportation to medical appointments, reminders for appointments, making sure medications are filled and other activities to help clients manage their care.

"Nevada has one of the fastest aging populations in the United States, and we need increasing resources and services to meet the needs of elders in our community. The entire team, including the elder client, will work together to understand each person and their strengths and needs," Reed said, adding that the staff won't be providing primary care medical services, but will work in conjunction with clients' primary care providers.

Initially, the clinic will be accepting only patients from primary care providers in the University of Nevada School of Medicine's internal medicine and family medicine departments in Reno with an intention to open the clinic to the larger northern Nevada community early in 2016.

"With the support of the EJC Foundation, we'll also be working with clients in Nevada's rural and frontier areas. Through a partnership with Nevada Health Centers and Project ECHO, we will offer educational and consulting opportunities to providers in rural areas via telemedicine technology," Reed said.

Initially, the staff providing services in the clinic will include Steven Phillips, M.D., Sanford's medical director; Kelley Macmillan, Ph.D., MSW, social services director; and Leslie Baker, Pharm.D., RPh, providing medication therapy management.

The center also is working to bring a geriatric nurse practitioner on board to round out the core interdisciplinary team.

Phillips pointed out that there is more to health care than medicine.

"There are four domains to health… functional, psychological, medical and mental. By using specific screening and assessment tools, we can identify and address our clients' risk of frailty, falls, cognitive limitations, psychological and behavioral concerns, and much more," said Phillips.

When discussing the new geriatric clinic, Macmillan said that the staff is committed to listening to what patients have to say about the care and services they choose to receive.

"Older adults want to be heard and we want them to know we will support them in their care goals," Macmillan said. "We're also working with many community partners and other resources to support our clients and their family members."

Thomas L. Schwenk, M.D., dean of the medical school and vice president of health sciences at the University of Nevada, Reno, is happy to offer this new service from the Sanford Center for Aging to northern Nevada.

"We are excited and proud to be able to offer a set of comprehensive wellness and specialty clinical services for older adults that are currently in short supply or nonexistent in northern Nevada. These special clinical programs are one more example of how the University of Nevada, Reno and the School of Medicine can contribute to the quality of life and quality of medical care for all of Nevada."