Innovative utilization of quality improvement processes to strengthen interdisciplinary geriatric care model

Hospitalization can be associated with an increased risk for nosocomial complications in older adults secondary to multimorbidity and the hospital environment. The complexity of care for older adults requires an interdisciplinary care team. The Geriatric Division at Hackensack University Medical Center, Hackensack, USA has incorporated various quality improvement frameworks to build an integrated interdisciplinary care model to improve health outcomes for hospitalized older adults.

The Geriatric Quality Council (GQC), an interdisciplinary team, has developed a geriatric care model, incorporating the HELP Program, Joint Commission Disease-Specific Care (DSC) certification, Patient Safety and Quality Department, and most recently, the Age-Friendly Health System. GQC creates interventions to improve care quality, oversees all care model activities, and monitors quality metrics. The interdisciplinary nature of this council allows for the exchange of ideas on intervention feasibility when planning and implementing interventions. This approach can be the key to successful implementation when planning trans-departmental interventions or quality improvement processes.

Our model uses a time series design that enables the GQC to monitor trends in real-time. This allows prompt identification of any roadblocks in the intervention's implementation. Timely changes are made to overcome barriers and meet the goal. This process continues until the intervention is fully implemented and the target goals are reached. Active tracking of the intervention's implementation is retired after consistency in numbers is attained.

Implementing our care model has helped improve clinical outcomes for hospitalized older adults at HUMC. Our approach suggests integrating quality improvement processes under the supervision of an interdisciplinary council. This allows timely interventions, access to resources, team engagement, dissemination of knowledge across various subspecialties, and sustainability. We recommend utilizing such strategies to improve and sustain care for older adults in the acute care setting.