Meet Rachel
Q&A with Rachel A. Roiland, RN, PhD from the Veterans Health Administration, Office of Geriatrics and Extended Care in Washington, D.C.
“Don’t pigeonhole yourself in terms of research, practice or policy. All three of those areas are equally important and if you can develop skill and comfort in all those areas, the likelihood of having an impact on practice is greatly increased.”
Q: How long have you been a GSA member?
A: I have been a member since 2008 and I became a member as a way to gain entry into the varied world of gerontological research. I knew this was the place where the best research in aging was presented and I wanted to make sure I was exposed to that work and the people who created it.
Q: You are a Hartford Change AGEnt. What is your Hartford affiliation and what was that project?
A: I am currently working as a Health and Aging Policy Fellow at the Veterans Health Administration (VHA) Office of Geriatrics and Extended Care. My projects for this fellowship include working on the development of transitional care policy within VHA and performance measurement for Geriatrics and Extended Care clinical programs.
Q: How did you become interested in the field of aging?
A: Like most people, I’ve had many great older adults in my life. My grandparents were a wonderful influence when I was younger and I always admired their grace, gentleness and goodness. Being with them as they aged and experienced health difficulties inspired me to go into the field aging with the goal of understanding how health care can maximize the strength and resilience of older adults.
Q: What practice change projects are you currently working on and what are your intended outcomes?
A: In collaboration with individuals from a variety of disciplines (e.g., social work, medicine, pharmacy), I am currently working on the development of transitional care policy for the VHA. We are aiming to identify various models of transitional care practice that can be tailored to the needs and capabilities of various VA Medical Centers and improve the transitional care experience and outcomes for older veterans. In addition to this project, I am working on a project related performance measurement for various Geriatrics and Extended Care programs. This project is examining current performance measures and developing a common platform for the sharing of these measures with GEC stakeholders.
Q: What was your inspiration for your practice change project?
A: My own clinical experience working as a registered nurse in post-acute care facilities was a major inspiration for my current interest in transitions, especially among frail, older adults. Admissions from the hospital were always stressful for me as a nurse but especially for the individual being admitted and their caregivers. In addition, in my post-doc I was also lucky enough to be mentored by GSA member Amy Kind, MD, PhD, a geriatrician and health services researcher at the University of Wisconsin-Madison and Geriatric Research Education and Clinical Center at the William S. Middleton Memorial Veterans Hospital. Kind is a nationally recognized expert in transitions of care and is a true champion for the importance of taking a systems approach to studying and improving transitions of care. Working with her, I learned the power of policy in influencing systems of care and this realization led me to seeking out opportunities to learn more about policy development and implementation.
Q: What are your key responsibilities at your job?
A: My key responsibilities include managing my two major projects (i.e., transitional care policy and performance measures projects) as well as serving as a VHA Liaison for the White House Conference on Aging and the Department of Health and Human Services 2015 Healthy Aging Summit.
Q: What has been your most memorable practice change challenge story?
A: My most memorable practice change challenge story goes back to a time when I was assisting on a qualitative research study examining transitions of care from the hospital setting to the skilled nursing facility setting. We had assembled about 6 nurses from the SNF setting to come and talk to us about their experiences with transitions and the first question was, “Tell us about a time when you had a really good transition from the hospital.” And there was silence. It was my first experience with qualitative research and the power of that non-response was so intense and memorable and further enhanced my appreciation for the power of talking to the individuals directly involved in the area of practice you want to change.
Q: Do you have any tips for emerging gerontologists and Change AGEnts?
A: I would say to talk to as many people from as many different disciplines as possible. The differing perspectives are so important to gather when seeking to understand an issue and these conversations can result in some really creative solutions. Also, don’t pigeonhole yourself in terms of research, practice or policy. All three of those areas are equally important and if you can develop skill and comfort in all those areas, the likelihood of having an impact on practice is greatly increased.
Q: Have you had an important mentor in your career or benefited from interdisciplinary relationships? If so, how did it make a difference?
A: I’ve had many important mentors so far in my career. My doctoral mentor, Susan Heidrich, PhD, was also a nurse and she was vital in my development as a researcher in terms of how to think critically about a research question and how to communicate effectively. While my work with Heidrich was focused on person-level characteristics and their relationship to their health, most post-doctoral work expanded my thinking to health systems and how to study the person within the health system. My post-doctoral mentors, Amy Kind, MD, PhD, and GSA Fellow Richard Allman, MD, are two physicians and their guidance was key to helping me expand my thinking.
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