The Institute for Healthcare Improvement initiative is promoting a four-part framework of evidence-based care for Americans over age 65.
The initiative is designed to improve care for the 46 million Americans over age 65—a population that is growing by 10,000 people daily. The primary focus of the initiative is promoting evidence-based care for this vulnerable population.
"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," IHI Senior Director Leslie Pelton said in a prepared statement.
The IHI initiative, which was launched in early 2017, features the 4Ms:
1. What matters to the patient: With a potentially dramatic impact on medical decisions, determining what matters to patients may be the most momentous of the 4Ms, Kedar Mate, chief innovation and education officer at Boston-based IHI, told HealthLeaders earlier this year. "Improving medical decision-making is a key element of attaining value. Of all the interventions, the first M—what matters—gets you to high value as defined by the patient. It gets you to services that offer value in the patient's eyes."
2. Medication: Managing medications is crucial for achieving therapeutic benefits and avoiding adverse drug reactions, which cause harm and costly complications. Annual costs in the United States associated with adverse drug reactions have been estimated at $30 billion, according to a December 2013 article in the Journal of Pharmacology & Pharmacotherapeutics.
3. Mentation: Addressing delirium in the inpatient setting generates significant mentation benefits, Mate said. "Delirium is extremely common among older adults in inpatient settings, and it is extremely costly both on the human cost side with complication rates and lengths of stay, and the financial side. Length of stay is often 20% to 30% longer with delirium."
4. Mobility: Maintaining mobility also generates clinical and financial benefits, he said. "The data on functional impairment is stark. If you have a patient with one or two chronic conditions, then you add on functional impairment, the cost of care roughly doubles. Functional impairment is a big impediment in older adults' lives in achieving what matters to them, and it costs us a ton of money as a society."
Last week, IHI recognized 162 hospitals and physician practices for their Age-Friendly Health Systems initiative adoption efforts.
Eighty-five of the healthcare organizations were designated as "Age-Friendly Health Systems—Committed to Care Excellence" for reporting the number of older adults reached with the 4Ms over at least a three-month period. The remaining 77 organizations were recognized as "Age-Friendly Health Systems Participants" for showing commitment to put the 4Ms into practice and submitting their plans for IHI review.
IHI and its partners in the Age-Friendly Health Systems initiative—The John A. Hartford Foundation, the American Hospital Association, and the Catholic Health Association of the United States—have set a goal to have 1,000 hospitals and physician practices adopt the initiative by 2020.
Hospitals and physician practices interested in joining the effort can get more information on the IHI website.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
The population of Americans over age 65 is growing by 10,000 people daily.
IHI's Age-Friendly Health Systems initiative features the 4Ms: what matters to the patient, medication, mentation, and mobility.
IHI and its partners in the Age-Friendly Health Systems effort have set a goal to have 1,000 hospitals and physician practices adopt the initiative by 2020.