The older adult population is growing sharply, and patients over the age of 65 are high utilizers of healthcare services. CMOs must be 4 steps ahead.
With older adults constituting the majority of patients in U.S. hospitals, it is essential for CMOs to be four steps ahead, says the CMO of Burke Rehabilitation Hospital in White Plains, New York.
As we know, the number of Americans who are 65 or older is sharply rising and is expected to increase from 58 million in 2022 to 82 million by 2050. During this period, the share of the total population of Americans who are 65 or older is expected to increase from 17% to 23%.
Members of this segment of the population are high utilizers of healthcare services, which makes adoption of age-friendly care at health systems and hospitals imperative, says Mooyeon Oh-Park, MD, MHCM, senior vice president and CMO at Burke.
"We need to think about who is using healthcare," Oh-Park says. "The vast majority of people using healthcare services are older adults."
At Burke, 72% of patients are 65 or older.
In 2023, Burke joined the Age-Friendly Health Systems movement, which is led by the Institute for Healthcare Improvement and The John A. Hartford Foundation in partnership with the American Hospital Association and Catholic Health Association of the United States. The movement is designed to accelerate and spread evidence-based care for older adults. A primary goal of the movement is to push adoption of four evidence-based elements of high-quality care for older adults, known as the 4Ms: medication, mobility, mentation, and what matters most to older patients and their families.
"Using the 4Ms of age-friendly care developed by IHI is improving outcomes for older adult patients," Oh-Park says.
According to Oh-Park, patient experience scores at Burke have improved significantly since the hospital adopted the 4Ms.
Age-friendly care innovations
Burke has launched several innovations to support age-friendly care over the past two years, Oh-Park says.
One innovation is use of CatchU, which is a digital app developed by neuroscientists at Albert Einstein College of Medicine. The app focuses on assessing the risk of falls among Burke's older adult patients and older adults living in the community, Oh-Park says.
For people to be able to move around without falling, they are constantly integrating visual stimulus and the feeling on the bottom of their feet. People react to that stimuli, which is why they do not fall. A person's ability to integrate multiple stimuli can predict future falls, according to Oh-Park.
"The CatchU digital app can measure how well a person can integrate multiple stimuli," Oh-Park says. "Based on the results of these measures, we can make a recommendation such as whether a person needs more balance exercise or needs counseling to avoid falls."
Another age-friendly care innovation that Burke has adopted does not involve technology. In inpatient rooms, the hospital has hung a "Get to Know You Board." Patients are asked to post things that could be a surprise to know about them such as what makes them happy, Oh-Park says.
"Within a couple days after admission, patients list things about themselves on the board," Oh-Park says. "It is a tool to develop a relationship with the patient and to recognize what is important to them, which is one of the four primary elements of age-friendly care."
Challenges of providing age-friendly care
Age-friendly care involves implementation of evidence-based practice, says Oh-Park, adding that high-quality implementation is always challenging, especially in complex clinical settings.
"One of the greatest challenges is bringing everybody on your staff on the same page and maintaining the initial excitement about age-friendly care," according to Oh-Park. "Then you must continue the momentum. Learning how to overcome these challenges is extremely rewarding for an organization, and it requires leadership skills and creativity."
Monitoring mentation is an example of an element of age-friendly care that requires all members of a clinical staff to be on the same page, Oh-Park says.
When older patients are admitted to Burke, they may be confused because of anesthesia, medication, or the unfamiliar environment, according to Oh-Park. To make sure the confusion is not related to an underlying condition such as dementia, the hospital has provided education about mentation to physicians, nurses, and other clinical staff.
"We can change medications or be on the lookout for a developing infection or dehydration," Oh-Park says. "Identifying changes in mentation requires everybody to be on the same page, including doctors, nurses, physical therapists, and family members."
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
The number of Americans who are 65 or older is rising fast.
The Institute for Healthcare Improvement is pushing adoption of four evidence-based elements of high-quality care for older adults, known as the 4Ms.
A key challenge for providing age-friendly care is making sure that all members of a clinical staff are on the same page such as a widespread ability to monitor mentation.