Creating a Culture of Engagement in Geriatric Specific Acute Care Education

General Information

Institution Name: Kaiser Permanente Fresno

Author Name and Title: Krystal Pombo, RN, CNS, AGCNS-BC, Lindsey Halstead, MSN, RN, NE-BC, Vanessa Matcham, BSN, RN, PCCN, GERO-BC, Sheryl Paul, BSN, RN, CCRN, GERO-BC, Nancy Her, MSN, RN, GERO-BC,  Amarjit Grewal, BSN, RN, MS-BC, GERO-BC, Leticia Rincon, BBA, RN, Connie Doria-Tiburcio, BSN, RN, Camille Joseph, MSN, RN, CMSRN, NE-BC, GERO-BC, Marie Commins, BSN, RN, GERO-BC, Allen Pasion, RN, Sharon Chettupally, BSN, RN, Lisa Louden, BSN, RN, Danny Nguyen, BSN, RN, GERO-BC, Jessie Saltzman, MSN, RN, FNP-C, GERO-BC, Tom Carillo, MSN, RN, GERO-BC

Name of Case Study: Creating a Culture of Engagement in Geriatric Specific Acute Care Education

Identification of Local Problem

The local problem identified in this quality improvement initiative was the growing mismatch between the increasing needs of the older adult population and the preparedness of healthcare staff to meet those needs in the acute care setting. The population aged 65 and older has rapidly increased and represents a significant proportion of hospitalized patients, who are at high risk for complications such as delirium and functional decline. Despite this, there were gaps in staff knowledge, confidence, and engagement related to geriatric-specific care, including delirium identification and prevention, sensory changes associated with aging, palliative care, and geriatric surgery considerations. These gaps highlighted the need for structured, targeted education to ensure evidence-based practices are consistently applied to improve patient outcomes.

Context of the QI Activity

The QI activity was an acute care hospital in Fresno, California, where a Geriatric Committee had been established in 2020 to advance nursing engagement, evidence-based practice, and quality improvement initiatives focused on older adults. Within this setting, the committee recognized the need for an innovative, multidisciplinary approach to education and developed a Geriatric Symposium. This intervention included collaboration between physicians and nurses and incorporated interactive learning strategies such as simulation and gamification to enhance engagement.

Interventions

Development and implementation of a Geriatric Symposium led by a multidisciplinary Geriatric Committee to include physician and nursing speakers, interactive breakout sessions, delirium escape room and geriatric sensory simulation.

Implementation Strategy

Implementation included use of an evidence-based practice quality improvement model with a SMART goal framework, conducting a pre- and post-intervention surveys to assess knowledge. Process measures included a pre-event Likert scale survey assessing self-reported knowledge across key geriatric domains, including delirium identification, palliative care, delirium prevention and interventions, the Geriatric Surgery Verification program, and sensory changes associated with aging. Outcome measures included a post-event Likert scale survey evaluating knowledge attainment after the symposium, along with overall event ratings and qualitative feedback. While participation was tracked through survey completion, additional process measures—such as attendance by role—were collected but not formally analyzed as part of this project. The symposium incorporated a combination of didactic lectures and simulation-based learning activities. The overall focus included multidisciplinary engagement and interactive learning.

Costs and Funding Sources

Funding supported internally through organizational resources and staff-led committee efforts.

Overall Results and Analysis

Results demonstrated a significant improvement in self-reported knowledge from pre- to post-surveys across all measured domains, with a consistent shift toward higher levels of competency. For delirium identification, the percentage of participants rating themselves as “very knowledgeable” increased markedly from 36.8% pre-assessment to 78.6% post-assessment, while lower categories decreased substantially. For delirium interventions and prevention, similar improvements were observed, with “very knowledgeable” increasing from 42.1% to 81.0%, accompanied by notable reductions in “somewhat,” “moderately,” and “minimal” knowledge levels. For sensory issues and aging, the greatest improvement was seen, with “very knowledgeable” increasing from 31.6% pre-assessment to 83.3% post-assessment, and complete elimination of the “minimal knowledge” category. Post-survey findings further reinforced the success of the intervention, with 92.9% of participants rating the event as excellent and reporting improved overall geriatric knowledge. Qualitative feedback highlighted strong engagement and satisfaction, with participants describing the symposium as “Best event,” “Engaging and fun,” “Thoroughly enjoyed,” and offering “Good takeaways.” Overall, the results demonstrate not only significant knowledge gains across all geriatric care domains but also strong staff interest and engagement, underscoring the need for continued, interactive geriatric-focused education initiatives.

Limitations

Limitations noted a reliance on self-reported knowledge rather than objective competency measures. Small sample size (Pre N=38, Post N=44) and no direct correlation to patient outcomes (planned for future study).

Lessons Learned

An interactive, gamified, and multidisciplinary approach increases engagement and knowledge retention. Facility noted a high demand for geriatric-specific education in acute care settings noting the importance of sustaining education through annual events and continued innovation. Future direction to include a direct link of education to measurable patient outcomes.