Using the 4M framework of the Age-Friendly Health System to improve MIPS documentation in primary care clinics: A quality improvement study

Tewary, Sweta; Cook, Nicole; Pandya, Naushira; Damier, Sashah; Shnayder, Oksana; Dezine, Marie

doi:10.1080/02701960.2022.2117171

Cited by 7 publications

(16 citation statements)

References 7 publications

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“…Main strengths of age‐friendly systems identified at the person level were the impact on individual outcomes 27,32,35,38,45,53,59,64,67,69,79,90 and incorporating patient priorities 31 and family in care 26,52 . Main strengths of age‐friendly systems identified at the system level was the impact of built environment (including transportation and recreational facilities) and organizational age‐friendly processes on persons' outcomes 59,64,83,90–92 …”

Section: Resultsmentioning

confidence: 99%

“… Community health, 68 sense of community, 38 and well‐being positively impacted by neighborhood characteristics, such as transportation and access to outdoor/indoor spaces 84 Built environment (housing, transportation) impact quality of life, 90 life satisfaction, and self‐perceived health 64 Exercise and recreational facilities associated with lower depression 59 Validated tool for AFS environment assessment 55,73 and community level indicators for AFS develped 53 AFS resulted in reduced length of stay and direct costs 32 Age‐friendly features associated with perceived age‐friendliness of community 46,57 AFS result in improved medication management, advanced care planning, and fall risk assessment 83 …”

Section: Resultsmentioning

confidence: 99%

“…• Age-friendly features associated with perceived age-friendliness of community 46,57 • AFS result in improved medication management, advanced care planning, and fall risk assessment 83 • Dependence on volunteers 32,71 and staff training 81 • Issues of scope, reach, and sustainability 79…”

Section: Systemmentioning

confidence: 99%

“…• Community history and identity impact AFS 83 • Walkability and transportation available in communities 35 • Incorporation of 4Ms into the annual wellness visit 67…”

Section: Systemmentioning

confidence: 99%

“…26,52 Main strengths of age-friendly systems identified at the system level was the impact of built environment (including transportation and recreational facilities) and organizational age-friendly processes on persons' outcomes. 59,64,83,[90][91][92]…”

Section: Strengthsmentioning

confidence: 99%

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Rural age‐friendly ecosystems for older adults: An international scoping review with recommendations to support age‐friendly communities

Liebzeit

Krupp

Bunch

et al. 2023

Health Science Reports

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Background and Aims: The population of older adults in rural areas is rising, and they experience higher rates of poverty and chronic illness, have poorer health behaviors, and experience different challenges than those in urban areas. This scoping review seeks to (1) map the state of the science of age-friendly systems in rural areas regarding structural characteristics, processes for delivering age-friendly practices, and outcomes of age-friendly systems, (2) analyze strengths, weakness, opportunities, and threats of age-friendly system implementation, and (3) make person, practice, and policy-level recommendations to support active aging and development of age-friendly communities.Methods: An international scoping review was conducted of articles that used agefriendly framing, had a sample age of 45 years of age or older, self-identified as rural, and reported empiric data. Searches were conducted in PubMed, CINAHL, AgeLine,

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Systemmentioning

confidence: 99%

“…• Community history and identity impact AFS 83 • Walkability and transportation available in communities 35 • Incorporation of 4Ms into the annual wellness visit 67…”

Section: Systemmentioning

confidence: 99%

Section: Strengthsmentioning

confidence: 99%

See 3 more Smart Citations

Rural age‐friendly ecosystems for older adults: An international scoping review with recommendations to support age‐friendly communities

Liebzeit

Krupp

Bunch

et al. 2023

Health Science Reports

View full text Add to dashboard Cite

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Age-friendly healthcare: integrating the 4Ms to enable age-friendly cancer care

Hodge,

Rasekaba,

Blackberry

et al. 2024

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review There is a growing movement towards person-centred, age-friendly healthcare in the care of older adults, including those with cancer. The Age-Friendly Health Systems (AFHS) initiative uses the 4Ms framework to enable this change. This review documents the utility and implications of 4Ms implementation across different settings, with a particular focus on cancer care. Recent findings The AFHS initiative 4Ms framework uses a set of core, evidence-based guidelines (focussing on What Matters, Medication, Mentation and Mobility) to improve person-centred care. The successful implementation of the 4Ms has been documented in many different healthcare settings including orthopaedics primary care, and cancer care. Implementation of the 4Ms framework into existing workflows complements the use of geriatric assessment to improve care of older adults with cancer. Models for implementation of the 4Ms within a cancer centre are described. Active engagement and education of healthcare providers is integral to success. Solutions to implementing the What Matters component are addressed. Summary Cancer centres can successfully implement the 4Ms framework into existing workflows through a complex change management process and development of infrastructure that engages healthcare providers, facilitating cultural change whilst employing quality improvement methodology to gradually adapt the status quo to age-friendly processes.

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An age‐friendly approach to primary care in an academic health system

Wismann,

Kleszynski,

Jelinek

et al. 2024

J American Geriatrics Society

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BackgroundAge‐friendly care, addressing what matters most, medications, mentation, and mobility, is a successful model for improving older adult care. We describe the initial outcomes of age‐friendly care implementation in five primary care clinics in an academic health system.MethodsIn partnership with a regional quality improvement (QI) organization, we used practice facilitation to implement age‐friendly care from July 2020 to June 2023. Clinic workflows and electronic health record (EHR) templates were modified to capture six QI measures for patients ≥65 years: Documenting what matters most to patients Advance care planning (ACP) Annual cognitive screening Caregiver referral to dementia community resources Fall‐risk screening Co‐prescription of opioid and sedative‐hypnotic drugs Providers were alerted if patients had positive screens and given support tools for clinical decision‐making. QI measures from January–June 2023 were compared to the year prior to implementation. Providers and staff were interviewed about implementation barriers and facilitators.ResultsAll six measures improved in Geriatrics and and other clinics showed improvement in ACP and cognitive screening. All clinics had high fall‐risk screening rates (≥85%). The least improved measure was co‐prescription of opioids and sedative‐hypnotics with co‐prescription rates ranging from 7% to 39%. Implementation hinged on leadership prioritization, practice facilitator guidance, clinical team buy‐in, EHR functionality, and clinical performance review. Three clinics received Age‐Friendly Health System recognition.ConclusionsA QI approach using practice facilitation and EHR templates improved some but not all age‐friendly care measures. Future interventions will focus on training in high‐risk medication tapering and elicitation of health goals.

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Using the 4M framework of the Age-Friendly Health System to improve MIPS documentation in primary care clinics: A quality improvement study

Cited by 7 publications

References 7 publications

Rural age‐friendly ecosystems for older adults: An international scoping review with recommendations to support age‐friendly communities

Rural age‐friendly ecosystems for older adults: An international scoping review with recommendations to support age‐friendly communities

Age-friendly healthcare: integrating the 4Ms to enable age-friendly cancer care

An age‐friendly approach to primary care in an academic health system

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