Special Projects Fund

Grantee Name

New York University College of Nursing

Funding Area

Special Projects Fund

Publication Date

January 2015

Grant Amount


Grant Date:

June 2010 – April 2014

New York State currently has the third-largest population of older adults in the United States.

Older patients experience more complications during hospitalizations compared to any other age group, resulting in a host of problems that include lower survival rates, loss of independence, increased usage of rehabilitation services, and new placements in nursing homes. As of October 2008, hospitals no longer receive Medicare payment for eight complications, three of which—falls/fall injuries, pressure ulcers, and urinary tract infections—are known to occur more frequently in older patients and are found to be reduced when geriatric care models are used. It is therefore a priority for hospitals to avoid the costs associated with these complications. The Nurses Improving Care for Healthsystem Elders (NICHE) program has emerged as a national leader in improving geriatric care and has been adopted by nearly 300 hospitals nationally, including 18 in New York State. NICHE provides evidence-based clinical protocols and operational tools developed to improve elder care, as well as builds geriatric staff member knowledge and competence within participating hospitals.

In 2010, New York Health Foundation (NYHealth) awarded a grant to the New York University (NYU) College of Nursing to expand NICHE in rural New York State.

Outcomes and Lessons Learned

  • Recruited 12 hospital sites to implement NICHE. Recruitment was difficult because many hospitals had competing priorities, namely on achieving meaningful use of a certified electronic health record, a federally financed incentive;
  • Determined that requiring three people per site to take the 6-week training program was not reasonable for small hospitals. It was decided that one person would be sufficient, reducing costs for participation from $4,950 to $1,650; and
  • Created a business plan to guide future project financing, including reduced annual fees from $5,000 to $2,500 for small hospitals unaffiliated with a health system.

At the time of the final report, NYU was unable to report on the remaining proposed outcomes. Because the majority of participating hospitals did not collect data pertaining to complications during hospitalizations, this outcome was ultimately eliminated from the final report. NYU continues to wait for data on the expected outcomes of increased work satisfaction and improved geriatric nursing knowledge. This delay is a result of the unexpected length of time it took to implement NICHE at the participating sites.