Leveraging Teams to Implement Age-Friendly Health Systems Across Settings in a Major Academic Medical Center

Area of Science:

• Geriatric Medicine
• Healthcare Systems Implementation
• Quality Improvement Science

Background:

• Age-Friendly Health Systems (AFHS) aim to improve care for older adults by focusing on the 4Ms: What Matters, Medication, Mentation, and Mobility.
• Spreading evidence-based practices like AFHS across diverse clinical settings presents unique implementation challenges.

Purpose of the Study:

• To describe the implementation strategies, successes, and challenges of spreading AFHS practices across various clinical settings within a large academic medical center.
• To evaluate the adoption and impact of the 4Ms framework in routine clinical care.

Main Methods:

• An 18-month System-Wide Spread Collaborative involving five clinical sites across three health systems.
• Interprofessional teams utilized Plan-Do-Study-Act cycles, weekly meetings, and chart reviews to track documentation and actions related to the 4Ms.

Main Results:

• Average patient assessment on all 4Ms was 49%, with 33% having all 4Ms acted upon.
• Facilitators included strong leadership support, effective use of the electronic health record (EHR), and comprehensive staff education.
• Challenges encountered were site-specific workflow variations and limitations in EHR functionalities.

Conclusions:

• Multisite implementation of AFHS is achievable, emphasizing the need for local adaptation and robust leadership engagement.
• Standardized documentation and tools are crucial for long-term sustainability of AFHS practices.
• Further alignment with upcoming Centers for Medicare & Medicaid Services quality measures is necessary.