THE APPLICATION OF HEALTH SYSTEMS SCIENCE CURRICULUM ON A GERIATRIC PSYCHIATRY INPATIENT UNIT

Abstract

Introduction Health Systems Science is one of the central tenets of undergraduate medical education at Penn State College of Medicine. While there is a clearly defined course in the first two years of the undergraduate curriculum, application of and more formal education of this in the clinical arena is variable. Geriatric patients, particularly those with underlying psychiatric illness, have unique needs including complex medical co-morbidities, cognitive impairment, and difficulty accessing community resources due to psychosocial, financial and insurance limitations, making them a more vulnerable population in terms of comprehensive health maintenance and stability within the community. When these individuals require admission to the inpatient psychiatric service, their hospital admissions are longer, and a systems level approach is necessary in their treatment and subsequent transition to the community in an effort to maximize stability and minimize risk of rehospitalization. Health systems science includes 12 curricular domains: 6 core domains (health care structures and processes; health care policy, economics, and management; clinical informatics/ health information technology; population health; value based care; health system improvement); 5 cross-cutting domains (leadership and change agency; teamwork and interprofessional education; evidence-based medicine and practice; professionalism and ethics; scholarship); and the linking domain of systems thinking. The inpatient geriatric psychiatry unit provides an environment in which these curricular domains coalesce in the overarching management of these individuals with complicated psychiatric, medical and social determinants. The scholarly question this project aims to address is how health systems science competencies can be taught within the sphere of geriatric mental health care, with the anticipated outcome being the creation of an elective for medical students during which time the 12 principles of health systems science are addressed, utilizing the backdrop of the geropsychiatry inpatient unit at Pennsylvania Psychiatric Institute. Methods This project aims to create a medical student elective in which the domains of health systems science are explicitly addressed in the geriatric psychiatric inpatient population at Pennsylvania Psychiatric Institute. This is an innovative approach in that it requires the application of health systems science to a population which is complex and underserved, both due to the “geriatric” and the “psychiatric” descriptors that fall upon it, and one that is not typically utilized in the teaching of health systems science. Potential educational strategies in this elective include the identification of social determinants of health for a patient facing discharge soon, rounding with the inpatient team with an emphasis placed on understanding the multidimensional factors that affect discharge planning, and the co-leading of a discharge meeting. Results The primary result of this project is the development of an elective in which health systems science is the primary focus, while geriatric psychiatry serves as the backdrop. We will plan to review the components of the elective created and how each component ties in with either the central or core cutting domain of health systems science. We will also review the steps necessary to consider in the development of this unique elective. Conclusions Health systems science is an emerging and evolving component of medical education. The geriatric mental health sphere is a unique and novel environment to allow for teaching of these principles. This research was funded by: not applicable