What is an Age-Friendly Health System? This is the question that the Hartford Institute and the Institute for Healthcare Improvement (IHI) set out to answer through a focused collaboration with five health systems, including the Providence St. Joseph Health Oregon region and Providence Senior Health. The initial phase of the effort has concluded, and PSJH is now committed to incorporating the key elements of this program across the care continuum.
Care of older adults is complex. To help focus improvements, four essential elements were identified. These are referred to as The 4Ms: What Matters; Medication; Mentation; and Mobility. The pilot participants focused on care settings outside the hospital. An exciting outcome of this work in Oregon is the creation of a Geriatric Mini-Fellowship designed to engage Providence Medical Group providers as champions and change agents in improvements in the 4Ms. Improvement areas include de-prescribing high-risk medications, assessment of fall risk, and engaging in a What Matters conversation. Providence St. Joseph Health recently committed to expand this initial work to address the 4Ms in acute care.
The 4Ms speak to the heart of nursing. For example, a fundamental nursing activity, care planning, allows nurses to engage with patients to learn what matters. Our imperative is to take that further, to communicate what matters to patients and to act on this information. PSJH is enhancing our inpatient care planning process; beginning with the Epic upgrade and Instance Alignment nurses will more clearly be directed to document and share what matters to the patient. This will eventually align with other Epic tools that cross the continuum of care so that what matters to older adults, and all patients, will be communicated to all caregivers. Nurses have also led important work in reduction of delirium, and consistently improving in this area is another goal of the Age-Friendly Health System initiative at PSJH.
Nurses and other caregivers can expect to hear more about the PSJH Age-Friendly Health System over the next few months as program planning ensues. The Nursing Practice & Quality team is gathering information about successful local programs, in-progress initiatives, and nurses with expertise and passion in the care of older adults. If you are interested in sharing information or participating in this project, please reach out to Katie McRae or Andria Moore.
Read more about the Age-Friendly Health System:
- Fulmer, T., Mate, K., & Berman A. (2018). The Age-Friendly Health System imperative. Journal of the American Geriatrics Society, 66(1), 22-24.
- Pelton, L., Mate, K., Fulmer, T., & Berman, A. (2018). Creating Age-Friendly Health Systems. Health Progress, Jan-Feb 2018, 87-88.