Becoming an AgeFriendly Health System Overview AgeFriendly Healthsystem
Becoming an Age-Friendly Health System
Overview: Age-Friendly Healthsystem National Initiative • US population ≥ 65 nearly double over the next 30 years, from 43. 1 million in 2012 to an estimated 83. 7 million in 2050 • 10, 000 people turn 65 every day • 100 people turn 100 every day • Age-Friendly Health Systems aim to: • Follow an essential set of evidence-based practices; • Case no harm; and • Align with What Matters to the older adult and their family caregivers
Age-Friendly Health System Partners • Goal: to rapidly spread the 4 Ms Framework to 20% of US hospitals and medical practices by 2020.
Recognized Organizations as of July/August 2020 185 Committed to Care Excellence 565 Participants
http: //aging. rush. edu/professional-older-adult-familycare/age-friendly-health-system/4 ms-framework/
Methodist Journey and Structure
And beyond……continuous improvement January - June – Celebrate 4 hospitals AFHS ~~ January – December – Celebrate Methodist Physicians Clinics AFHS January – Refine Processes February – Retreat ~~ COVID-19!!!!! May - December Action Plans 2019 Start 2021 2020 Jan- February – GOT Committee February – Started IHI webinars March – Defined 4 Ms March – 4 Ms Subcommittees formed April – Pilots Identified April/December Action Plans
Acute Care for Elders Unit Team 8
Indian Hills Primary Care Team 9
Healthwest Primary Care Team 10
What Matters Most Ambulatory Hospital • “What matters most to you overall? ” • Advance Care Planning • As you think about the future and your health care goals, what is the one thing you most want to focus on? • Who is your health partner? • Cerner documentation • “What Matters Most to You today? ” • “My Story” posters • Handoff to next shift • Cerner documentation to be determined
Medications Ambulatory Hospital • Cerner alerts for high risk medications • Provide education and support for deprescribing high risk medications • Provider, staff and patient education • Deprescribing guidelines patient education • Filtering high risk meds, from Provider orders • Antipsychotic PI project • Education Pharmacy and Therapeutics Newsletters • Education – Providers, pharmacists, staff
Deprescribing Medications Geriatrician, Elana Shpall, created this mosaic from the pills that she deprescribed from older adults.
Mentation Ambulatory - Depression and Dementia • “ 65+ Clinic Check in” Cerner • Mini-cog • PHQ 2 - + results to PHQ 9 • Developing training guidelines and protocols for clinical staff • Educate Providers, pharmacists, staff on geriatric resources available including neuropsychology testing, counseling • Patient education Hospital - Delirium • Prevention is key! • Nursing Delirium Screening Scale –Nu. DESC q shift outside of the ICU who does the CAMICU • Nursing Care Plans • Patient Education for Families/Health Partners • Education for staff, Providers, pharmacists
Mobility Ambulatory • Fall risk assessment (STEADI) • Refer to PT, Methodist Hospital Fall and Balance clinic • Community resources Hospital • Banner Mobility Assessment Tool (BMAT) in Cerner • Mobility Plan and Goal for each patient in Cerner • ACE unit has Restorative Aide
Scaling Up 4 Ms • 4 Ms Subcommittees continue and expand to additional units at Methodist Hospital. • Discussions with Methodist Estabrook Cancer Center aligning the 4 Ms within their existing Cancer Survivorship Programs. • Methodist Freemont Health and Methodist Jennie Edmundson teams developing. • Collaborate with Community Partners and Nebraska Hospital Association. • Finalize 4 Ms data dashboards. • MPC’s focus is on Annual Medicare Wellness Visits.
Contact Information: Deborah Conley, MSN, APRN-CNS, GCNS-BC Service Executive Geriatrics Methodist Hospital Deborah. conley@nmhs. org
References/Resources • Institute for Health Care Improvement (IHI) http: //www. ihi. org/Engage/Initiatives/Age-Friendly-Health. Systems/Pages/default. aspx • John A. Hartford Foundation https: //www. johnahartford. org/grants-strategy/current-strategies/agefriendly/ • Rush University excellent videos https: //aging. rush. edu/professional-older-adult-family-care/age-friendlyhealth-system/
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