NICHE and GEM: Geriatric Care Programs

Compassionate Geriatric Expertise

As we age, our healthcare needs can become more frequent. Older adults often experience functional decline brought on simply by aging alone. We can become at risk for a variety of conditions that can be challenging for caregivers such as dementia, delirium, and frailty. When selecting a healthcare partner, you can have peace of mind that Community Hospital North offers a combination of compassionate care and the expertise to understand and address the physical, psychological, and social needs of older adults.

Evidence-Based Care for Better Patient Outcomes

NICHE designated programIn 2016, the nursing care team at Community Hospital North instituted the Nurses Improving Care of Healthsystem Elders (NICHE) program. NICHE is a national nurse-driven membership organization that encourages hospitals to adopt its tested principles, protocols and model of care. This innovative program is dedicated to the highest level of care for our aging patients. The NICHE goals fit perfectly with Community’s culture of patient-centered care.

Our program is led by a nurse practitioner who specializes in geriatrics, and who helps guide clinicians, care providers, and nursing staff in providing sensitive and responsive geriatric care with an ongoing, high-level dedication to our aging population. NICHE evidence-based principles are embedded across the hospital, which means older adults receive high-quality, interdisciplinary care that leads to better outcomes.

Patient Care that Includes Families

At Community Hospital North, care for older adults extends beyond health maintenance. Rather, we look for opportunities to improve health beyond a hospital stay or appointment with us. We believe communication with patients and their family members is crucial to providing care and achieving better health outcomes.

Older adults are hospitalized three times more than the general population and that number is expected to grow. Through 2030, more than 10,000 baby boomers will turn 65 every day.

    Geriatric Evaluation & Management (GEM)

    The Geriatric Evaluation & Management (GEM) team is an inpatient, geriatric consult service for individuals hospitalized over the age of 65.  This specialized, interdisciplinary care team excels in focusing on the needs of the aging patient during a hospitalization, as well as the needs of both the individual and caregiver at discharge. The GEM team works closely with the primary medical team during an individual’s hospitalization to ensure additional support for individuals navigating the aging process.

    A part of Community Health Network, the GEM team includes a geriatrician - a physician specializing in the care of older adults - a geriatric nurse practitioner, a social worker case manager, a registered nurse, a pharmacist and a physical therapist. Our clinicians each bring a unique perspective and expertise to an individual’s care, and daily rounds assist in creating a unique care plan based on individual and caregiver preferences and needs.

    The GEM team’s focus is to help older adults stay independent, especially when an acute hospitalization can cause further decline for seniors. Our assessment focuses on common issues related to aging – medication review and utilization, nutrition screening, mobility concerns, memory changes, mood or sleep problems, caregiver resources, and discharge planning. Our team is available to provide assistance and information on desired services and resources available throughout Community Health Network and local communities.

    Our clinicians are credentialed with all of the major insurance providers, including Medicare.

    The GEM team is currently located at Community Hospital North on two units, with plans to expand to the entire hospital by the end of 2017. Services are available Mondays through Fridays, excluding holidays.

    Kimberly Moran, NP

    Kimberly Moran, RNKimberly Moran, RN, MSN, AGNP, received her RN Diploma from St. Elizabeth School of Nursing in 1995. Between 1995 and 2014, Kimberly’s professional experience included years in intensive care, management of an interdisciplinary team providing leadership in the care of patients in the home environment, and telehealth care for heart failure, COPD, diabetes and joint replacement patients.

    Kimberly furthered her education, obtaining her BSN and MSN at the University of Indianapolis beginning in 2014 through 2017 to strengthen and enhance her skills, knowledge and experience in gerontology due to her passion for the geriatric population and their quality of life. During this time, Kimberly was part of a small team which developed a Reminiscence Therapy program for dementia patients.

    Her affiliations include Sigma Theta Tau International Honor Society of Nursing and the American Association of Nurse Practitioners (AANP). She has also assisted with opening a health clinic for a village and treating patients during a 10-day mission trip to Haiti.

    Kimberly’s interests include spending time with her husband and three children, walking the dog, hiking, and enjoying nature.

    Cassandra Farmer, BSN, RN

    Cassandra Farmer, RNCassandra acquired her BSN in 2008 and is currently completing her master’s degree in nursing in adult-gerontology primary care through the IU School of Nursing. She is a member of the American Nurses Association, the Indiana State Nurses Association, and the Sigma Theta Tau International Nursing Honors Society. She has nine years of prior nursing experience at Community, including in Neurology, PCU/ICU, and Clinical Documentation Improvement. Her career in geriatrics was influenced by her grandmother, also a geriatric nurse. Her areas of interest include the role of nutrition in aging and the relationship between sensory impairment and cognitive decline.

    Cassandra lives with her husband, four children, two dogs and a tortoise. In her spare time, she enjoys spending time with her family, hiking and reading.

    April Rowan, PT

    April Rowan, PTApril is a licensed physical therapist and has been practicing for over 16 years. She obtained her bachelor of science degree from The University of the East in the Philippines. Before she joined Community, April worked at various rehabilitation settings in the Philippines and the USA including outpatient, acute and extended care facilities where she experienced numerous opportunities to provide care and education to the geriatric population. She started as an inpatient medical-surgical physical therapist float with Community in 2006; she transitioned to a staff physical therapist at Community Hospital North the next year. Today, she provides services to patients with various conditions at Community North and Community Heart and Vascular Hospital, including the geriatric population as they experience the normal challenges of aging.

    April and her husband, Chad, are close to both of their families and also maintain strong relationships with several groups of friends. Outside of work, April and Chad enjoy traveling, spending weekends in the lake, and cheering for Indiana sports teams.

    Erin Wire, MSW, LSW

    Erin Wire, MSWErin is a licensed social worker who graduated from Ball State University with a bachelor’s degree in social work in 2005. She later received her master’s degree in social work from IUPUI. Erin started working with case management at Community Hospital North in December 2015. Prior to joining the Community, Erin worked at the Marion County Public Health Department and CICOA. She has more than 10 years’ experience in the social work field. She is excited to be a part of the new geriatric inpatient program at Community North.

    Erin lives in downtown Indianapolis and enjoys trying out new places in the city. She also enjoys volunteering, reading, and traveling with family and friends.

    Laura Gulden, PharmD 

    Laura received her doctor of pharmacy degree from Butler University. She has been a clinical pharmacist at Community Hospital North since 2014. She has worked with the resource team and cross-trained at Community East Hospital and Community Cancer Center North. Today, she covers the Medical-Surgical Unit at Community North.  

    Laura and her husband, Troy, were married in August 2016 and live in Zionsville with their dog, Mila. In her free time, she enjoys traveling, cooking, and watching everything Butler basketball related. Go Dawgs! 

    Darami Daniels MS, RN

    Darami Daniels, educatorDarami is a registered nurse employed as an educator at Community Health Network. She began her career at Community in 2008 as a patient support partner at The Indiana Heart Hospital and transferred to the Ortho-Neuro-Spine (ONS) unit at Community Hospital North shortly after. On ONS, Darami participated in many unit activities while obtaining her bachelor of science in nursing from Marian University. In 2015, Darami obtained her master of science in nursing (MSN) with a concentration in nursing education from Ball State University.

    Darami has always had a special place in her heart for the geriatric population - a result of time spent with her grandparents during summer breaks. As an educator, Darami has the privilege of assisting in the orientation process and professional development of staff for five units at the Community North campus. She also serves on several committees and is the education coordinator for the NICHE program.

    Darami and her husband, Scott, are high school sweethearts and enjoy traveling, eating at new restaurants and spending time with family. Darami is also an active member of her church and enjoys teaching women about skincare and color cosmetics.

    GEM and NICHE Leadership

    Georges El Hoyek, MD

    Georges El Hoyek, geriatric care physicianDr. El Hoyek received his doctorate degree from Lebanese University School of Medicine. He completed an internal medicine residency at St. George Medical Center, a family medicine internship/residency at University of North Dakota, and a geriatric fellowship at University of Nevada School of Medicine. He is a certified medical director and most recently served as a hospitalist at Trinity Hospital.

    He is a member of AMA, AGS, AMDA, AAFP, and Alpha Omega Alpha. He has a special interest in geriatric syndromes (frailty, fall, gait impairment), dementia/delirium/depression and geriatric acute/post-acute/long term care. He also has an interest in development and implementation of geriatric models of care.

    He enjoys skiing, golfing, tennis and travel.

    Margaret “Molly” Campbell, RN, MSN, AGPCNP-BC

    Molly Campbell, RN, NP, director of inpatient geriatric careMargaret “Molly” Campbell, RN, MSN, AGPCNP-BC, is the director of inpatient geriatric care at Community Hospital North (CHN). Molly brings more than 10 years of geriatric knowledge and healthcare experience to this new role. She works closely with north region leadership, medical staff, employees, and the public to support the Network mission, vision, and goals in promoting the development of a leading geriatric care model. 

    Molly received her bachelor of arts degree in gerontology from Miami University in Oxford, OH.  She then entered a three-year program at Yale School of Nursing in New Haven, CT, to obtain her RN and master’s degree in nursing.  Molly’s nursing career began as a student nurse and then a registered nurse for cardiothoracic and peripheral vascular patients at Yale New Haven Hospital.

    Molly’s professional certifications and associations include American Nurses Credentialing Center (ANCC) Certification in Adult and Geriatrics; nurse practitioner license; registered nurse License; CPR trained; American Geriatrics Society member; Indiana Geriatrics Society member; Coalition of Advanced Practice Nurses of Indiana member; and American Academy of Nurse Practitioners member.

    Contact NICHE

    For more information about the NICHE geriatric care program, please contact Molly Campbell at 317-621-6161 or mcampbell3@eCommunity.com.

    Additional Resources

    At Community, we offer comprehensive outpatient services to assist older adults, including: