Hospital 4Ms: Documentation and association with patient characteristics.

Area of Science:

• Geriatric Medicine
• Health Services Research
• Quality Improvement

Background:

• Thousands of health systems are recognized as Age-Friendly, focusing on integrating the 4Ms (What Matters, Medication, Mentation, Mobility) into care.
• This study investigates the documentation of these 4Ms and its association with patient characteristics in an inpatient environment.

Purpose of the Study:

• To evaluate the associations between the documentation of the 4Ms and patient characteristics within an inpatient setting.
• To identify patient and hospitalization factors linked to the varying levels of 4Ms documentation (not, partly, fully documented).

Main Methods:

• A prospective cohort study was conducted in an Acute Care for Elders (ACE) unit that had adopted the 4Ms framework.
• The 4Ms were categorized into not, partly, and fully documented based on assessment and action processes.
• Electronic health records were analyzed for patient and hospitalization characteristics, with descriptive statistics used for evaluation.

Main Results:

• The study included 620 hospital encounters from 573 patients, with a median age of 80 years; 85% were White.
• Documentation varied widely, with 'What Matters' having the lowest (67% not documented) and 'Medication' the highest (73% fully documented).
• Age and hospital length of stay were significantly associated with the documentation levels of various 4Ms, particularly Mobility and Medication.

Conclusions:

• A structured method was developed to categorize 4Ms assessment and action processes into documentation levels (not, partly, fully).
• Key patient and hospital characteristics associated with each documentation level were identified.
• Findings offer insights for improving 4Ms adoption and uptake, guiding future quality improvement efforts in geriatric care.