Guiding Post-Hospital Recovery by 'What Matters:' Implementation of Patient Priorities Identification in a VA...

Area of Science:

• Geriatric Medicine
• Quality Improvement
• Health Systems Science

Background:

• Patient Priorities Care (PPC) is a key component of Age-Friendly Health Systems (AFHS), focusing on aligning care with patient-defined 'what matters'.
• Evaluating the implementation of the Health Priorities Identification (HPI) process within VA Community Living Centers (CLCs) is crucial for improving geriatric care.

Purpose of the Study:

• To assess the fidelity and feasibility of integrating the Health Priorities Identification (HPI) process into the VA Community Living Center (CLC) setting.
• To determine the appropriateness and impact of the HPI process on person-centered care within CLCs.

Main Methods:

• A quality improvement project utilizing the Plan-Do-Study-Act (PDSA) model guided the integration of HPI into CLCs.
• PPC experts collaborated with CLC staff, reviewed HPI encounters and interdisciplinary team meetings for fidelity, and conducted qualitative interviews with staff.

Main Results:

• Nine facilitators completed 20 HPI encounters over 8 months.
• Implementation of a dedicated note template, staff education, and facilitator training enhanced HPI fidelity and electronic health record documentation.
• Staff interviews indicated PPC is appropriate, not burdensome, and promotes a person-centered approach within the AFHS framework.

Conclusions:

• The Health Priorities Identification (HPI) process is an acceptable and feasible method for incorporating the 'what matters' aspect of Age-Friendly Health Systems (AFHS) in CLCs.
• This quality improvement initiative demonstrates successful integration of patient-centered priorities into the CLC environment.