What Matters Most: an Age-Friendly approach to pathology and laboratory medicine

Under the Age-Friendly Health System initiative, "What Matters" is defined as knowing the older adult's specific health outcome goals and care preferences. This involves multiple settings of care (e.g., hospital, skilled nursing facility, outpatient visits) and can include end-of-life care. However, the establishment of testing frequency criterion and the development of wide-scale diagnostic algorithms are often left undefined in older adults with poor prognosis and/or shortened life expectancy. Thus, multidisciplinary development of Geriatric 5M-informed optimization plans at the institution level and quality improvement strategies within the laboratory community may further the successful implementation of age-friendly efforts. While patients, end-users, and systems can attribute to implementation barriers, the development of an evidence-base wherein laboratory expertise is directly associated with patient outcomes is vital. Thus, a concentrated, cooperative age-friendly approach centered on What Matters may present a sustainable strategy for early transformation. Future research centered on piloted interventions on the laboratory's role in older adult care and end of life diagnostic management is needed.