Shifting Culture Toward Age-Friendly Care: Lessons From VHA Early Adopters.

Area of Science:

• Geriatrics
• Health Services Research
• Public Health

Background:

• The aging US population necessitates a healthcare workforce skilled in geriatric care.
• The Age-Friendly Health Systems (AFHS) framework addresses the complex needs of older adults with multiple chronic conditions using the 4Ms (what matters, medication, mentation, mobility).
• The Veterans Health Administration (VHA) is becoming the largest AFHS due to its large elderly veteran population.

Purpose of the Study:

• To share lessons learned and identify opportunities for sustaining age-friendly care within the VHA.
• To highlight the challenges and successes of implementing the AFHS framework in a large healthcare system.

Main Methods:

• Implementation of the AFHS framework across various VHA facilities and care settings.
• Focus on the 4Ms (what matters, medication, mentation, mobility) as core components of care.
• Utilizing electronic health records (EHR) for data capture, reporting, and feedback.

Main Results:

• High patient engagement with 4M care (85%-100%) achieved within 3 months across all settings.
• Critical success factors identified: strong leadership support, dedicated champions, and EHR integration.
• Initial adoption was facilitated by focusing on geriatrics-specific care settings.

Conclusions:

• Early adopters in two VHA systems successfully implemented AFHS across diverse settings.
• Leveraging EHRs is crucial for reducing documentation burden, standardizing care, and automating reporting for sustainability.
• Ongoing efforts aim to integrate AFHS into VHA documentation, performance metrics, and EHR systems (legacy and Cerner).