Across healthcare systems, “siloed” practices have long limited the continuity of care— particularly for older adults with complex, chronic needs. In response, a new National Geriatric Interprofessional Training Initiative (NGITI) aims to dismantle those barriers by aligning public health competencies with frontline clinical education. The model, recently introduced through a consortium of universities, teaching hospitals, and community health agencies, reframes geriatric training around one core principle: that health outcomes for aging populations depend on interdisciplinary fluency, not isolated expertise.
From Fragmentation to Integration
Traditional geriatric care has often operated through distinct professional silos—medicine, nursing, social work, nutrition, pharmacy—each optimizing its own protocols but rarely converging in shared planning. The NGITI’s framework explicitly challenges that paradigm by embedding cross-disciplinary rotations and population-based modules within both academic and clinical settings. The goal is to bridge upstream public-health prevention strategies with bedside clinical management, ensuring that professionals learn to navigate the full care continuum rather than a single segment.
Program architects describe this as a “whole-systems training architecture”—a design that threads epidemiologic literacy, chronic-disease surveillance, and community-based gerontology into traditional clinical competencies such as diagnosis, pharmacologic management, and end-of-life planning. Learners engage in integrated case conferences where epidemiologists, primary-care physicians, and rehabilitation specialists collaboratively map care pathways that reflect social determinants as much as medical status.
Interprofessional Core: Speaking a Shared Clinical Language
At the heart of the initiative lies its Interprofessional Core Curriculum, co-developed by the National Public Health Association and the Council for Clinical Education Reform. This curriculum reframes the concept of “competence” from profession-specific mastery to interprofessional accountability. Learners are assessed not only on clinical acumen but also on their ability to translate between the dialects of disciplines—bridging the jargon of community health metrics with the bedside lexicon of acute care.
Simulation labs now replicate complex geriatric scenarios where multiple professions must co-manage treatment plans in real time. A single patient case might include home-care data, community infection-rate dashboards, and hospital charting—all within one integrated
electronic health record (EHR) ecosystem. These simulations underscore that effective care coordination requires professionals who can interpret and act upon multi-sector data, not just discipline-specific charts.
A New Model of Workforce Readiness
The NGITI’s policy framework aligns with national workforce-development goals outlined by the Public Health Workforce Modernization Act. Participating institutions will receive funding incentives tied to measurable interprofessional outcomes—for instance, reductions in avoidable hospitalizations among program-served older adults or improved vaccination coverage through cross-sector outreach.
The initiative’s evaluation metrics are as hybridized as its pedagogy. Performance indicators range from clinical efficiency metrics (e.g., reduced medication errors in geriatric polypharmacy) to population-level health markers (e.g., community fall-injury incidence rates). Data analytics teams will map these outcomes to interprofessional collaboration intensity, effectively quantifying the “ROI of collaboration.”
Embedding Public Health into Clinical DNA
What distinguishes NGITI from prior reforms is its deliberate fusion of public-health competencies into the DNA of clinical training. Trainees learn to read surveillance data, conduct neighborhood-level health assessments, and apply epidemiological reasoning to bedside care. In one pilot site, internal-medicine residents collaborated with public-health nurses to analyze influenza-vaccination uptake patterns across assisted-living facilities, adapting their clinical outreach accordingly. This approach converts abstract population data into direct clinical interventions.
The program also leverages shared informatics infrastructure—a national data exchange platform that allows seamless interoperability between public-health registries and hospital EHRs. This integration ensures that future geriatric clinicians will no longer have to rely on siloed datasets or delayed reporting when making patient-level decisions.
Cultural Transformation in Practice
Beyond technical integration, NGITI acknowledges that the larger challenge lies in shifting professional culture. It calls for dismantling not just institutional silos but also attitudinal ones—encouraging humility, cross-disciplinary respect, and an understanding that no single profession owns geriatric expertise. Faculty development programs emphasize team-based leadership, reflective practice, and systems thinking as essential attributes of modern clinicians.
Dr. Helena Morton, the initiative’s lead policy advisor, summarized it succinctly: “Breaking silos isn’t just about merging departments—it’s about merging mindsets. We’re training clinicians who think like public-health professionals and public-health practitioners who act with clinical precision.”
Looking Ahead
As the NGITI scales nationally, it is poised to become a model for how professional education can evolve to meet the demographic and epidemiologic realities of aging societies. By fusing public health and clinical training, the program moves beyond coordination toward true integration—a future where interprofessional collaboration is not an elective competency but the operating system of geriatric care.
