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Birgitte Graverholt

2016-2017 Harkness Fellow Head of Centre for Evidence-Based Practice Bergen University College


Placement: Brown University School of Public Health

Mentor: Vincent Mor, Ph.D. (Professor of Medical Science and Florence Pirce Grant University Professor of Community Health, Brown University School of Public Health)

Project Title: Reducing Hospitalizations from Nursing Homes

Birgitte Graverholt, Ph.D., M.S.N. is a 2016-17 Norwegian Harkness/Research Council of Norway Fellow in Health Care Policy and Practice. In addition to her current role as Head of the Centre for Evidence-Based Practice at Bergen University College, she serves as an advisor in the Research and Development Department at Helse-Bergen Health Trust, Haukeland University Hospital. Since 2014, Graverholt also has a role as Associate Editor of the Journal of Clinical Nursing. She currently serves on a 5-year steering committee reciprocal competence program between the municipality of Bergen and Helse-Bergen Health Trust, which was developed as a result of her Ph.D. work around acute hospital admissions from nursing homes, to address the needs of acutely ill nursing home residents. Graverholt has a background in nursing and received a Ph.D. from the University of Bergen, and a masters in clinical nursing from Flinders University, Australia.

Project Abstract:

Nursing homes are a corner stone in the long-term care of the frail elderly, a group of people that continues to become more medically complex. For ‘high need, high cost’ nursing home patients, research shows that the care provided in these facilities operates similarly to acute care services. Hospitalizations from nursing homes are common, but represent disruptive incidents that place the already frail elderly at risk for complications and reduced levels of functionality. Within the U.S. health care system Nurse Practitioners have a critical role in providing primary care, as the Nurse Practitioner presence in nursing home facilities has increased steadily over the past 30 years while the number of physicians has markedly declined. The impact that Nurse Practitioners may have on hospitalization rates from nursing homes has been studied in the past, but the work is out of date given how dramatically the landscape of medical care has evolved. This research will examine the association between Nurse Practitioners in nursing homes and hospitalization rates as well as the factors impacting the utilization of Nurse Practitioners in nursing homes, and will include a review of current research in this area. The findings from this research will not only be relevant in the U.S. context, but in other countries where nursing homes are a part of the long-term care system. Findings may inform future policy strategies at the intersection between acute and long-term care, such as workforce and education issues.