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A Maturing Field: Age-Friendly Health Care

The Institute for Healthcare Improvement (IHI) recently recognized 162 hospitals and health care practices as Age-Friendly Health Systems Participants, with 85 of these designated as Age-Friendly Health Systems — Committed to Care Excellence. These organizations are leading the way in improving care for the 46 million Americans over the age of 65, a population that grows by 10,000 every day.

Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and IHI in partnership with the American Hospital Association and the Catholic Health Association of the United States. Age-friendly care focuses on four essential elements, called the 4Ms Framework: what matters to older adults; medication, if needed, that is age friendly; attending to mentation, including delirium, depression, and dementia; and mobility to maintain function.

Many older adults have a complex set of health needs, often including multiple chronic conditions. “It is often difficult for hospitals and primary care practices to reliably deliver evidence-based care to older adults. This can be disheartening to our health professionals and, of course, causes harm to older adults and their family caregivers,” says Leslie Pelton, MPA, senior director at IHI. “What’s drawn health professionals to the Age-Friendly Health Systems movement is that it offers an organizing framework of evidence-based care that can be practiced reliably. And it all starts with knowing and acting on what matters to the older adult.”

The hospitals and health care practices recognized as Age-Friendly Health Systems — Committed to Care Excellence have shown exemplary alignment with the elements of the 4Ms Framework by reporting the number of older adults reached with the 4Ms over at least a three-month time period. Age-Friendly Health Systems Participants are hospitals and health practices that have committed to putting the 4Ms into practice and had IHI review their plans.

Additionally, more than 300 other hospitals and health care practices are taking steps to implement age-friendly care through participation in Action Learning Communities or other collaborative programs offered by IHI and the initiative’s partners. Hospitals and health care practices interested in joining the movement can find options for getting involved at

The four hospitals and more than 20 clinics that are part of Methodist Health System in the Omaha, Nebraska, area among the organizations recognized by IHI. “When we learned about the 4Ms Framework, we decided we wanted to create a systemwide solution for the unique needs of older adults,” says Deborah Conley, MSN, APRN-CNS, GCNS-BC, service executive and gerontological clinical nurse specialist.

“We had long been involved with various geriatric models of care, but they weren’t applied to every patient every time across our system. The 4Ms Framework brings an awareness of staff to look at older adults with specific and individual needs and create a plan of care to address those needs.”

IHI and its partners seek to spread the age-friendly framework to 1,000 hospitals and practices by the end of 2020.

“We congratulate and applaud the 162 hospitals and practices that have been recognized by IHI for demonstrating their commitment to age-friendly care,” says Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation. “These health care teams are leaders at the vanguard of a rapidly growing social movement to ensure that every older adult in every setting gets safe, evidence-based care. We and our partners look forward to learning from these Age-Friendly Health Systems and helping others to follow in their path.”

Source: Institute for Healthcare Improvement