Assessing the Utility of the Project ECHO Platform in Advancing the Knowledge, Skills and Abilities of the Healthcare Workforce to Improve the Health of Older Adults

Purpose: The population of older adults aged 65+ years is expected to increase by 262.9% from 2010 to 2050, thus significantly straining the geriatric care and long-term care (LTC) workforces. In addition to this, the COVID-19 pandemic has exacerbated existing strains placed on these workforces. To address these issues, the University of North Texas Health Science Center (UNTHSC) Center for Older Adults partnered with the Extension for Community Health Outcomes (ECHO) Institute to develop training and education for the LTC and geriatric care workforces. Methods: UNTHSC hosted weekly Nursing Home STRONG (NHS) ECHO training sessions targeted to LTC staff and bi-weekly Geriatrics ECHO training sessions targeted to geriatric providers. Virtually delivered NHS sessions featured specialist-led didactic presentations followed by interactive breakout discussions surrounding dementia care, IPC, workforce considerations, quality improvement, and age-friendly healthcare. Geriatric ECHO sessions followed a slightly different format; specialist-led didactic presentations were generally shorter with more time devoted to case study discussions. Topics covered during the Geriatric ECHO sessions included various aspects of dementia and cognitive impairment. Participants in both the NHS and Geriatric ECHO programs completed post-session surveys to track changes in knowledge, skills, and abilities using a five-point Likert scale. NHS participants completed a single post-session survey, while Geriatric ECHO participants completed bi-weekly surveys following the completion of each didactic session. Results: Between September 2021 and November 2021, 54 unique attendees representing 35 LTC organizations from 20 counties participated in NHS ECHO sessions. Importantly, 9 of the counties (45%) reached by the NHS ECHO were rural. A total of nine, 1-hour sessions were presented with an average of 17 attendees (excluding staff/facilitators), primarily including administrators (29.6%) and nurses (29.6%). Post-session respondents (n=10) "strongly agreed" that their knowledge of approaches to meet resident healthcare needs improved (90%), their knowledge of IPC improved (80%), and their ability to care for residents improved (80%) after attending at least one session. During this same time-period, 48 unique attendees representing 21 organizations participated in Geriatric ECHO sessions. A total of four, 1-hour sessions were presented with an average of 12 attendees, primarily including physicians (35.4%) and nurses (12.5%). Post-session responses indicated that majority of respondents "strongly agreed" that the session provided practical suggestions that can be applied in their practice (66.7 - 84.2%), the didactic topic was relevant to their learning needs (74.1 - 86.4%), and the case discussion was relevant to their learning needs (70.4 - 86.4%). Conclusions: Amidst various factors that increase burden on the healthcare workforce, the Project ECHO model offers an innovative virtual platform to adequately prepare diverse healthcare workforces to care for an aging population. This model has strong potential to improve future healthcare training and quality especially due to two unique features; collaborative, discussion-based instruction and the capacity to reach diverse and rural populations. Post-session survey responses suggested that the knowledge, attitudes, and skills of ECHO participants were improved via attendance in the NHS and/or Geriatric ECHO sessions.