The IHI Age-Friendly Health Systems Action Community: An Invitation to Join Us

Transcription

1 The IHI Age-Friendly Health Systems Actin Cmmunity: An Invitatin t Jin Us April - Octber 2019 This cntent was created especially fr: An initiative f Jhn A. Hartfrd Fundatin and Institute fr Healthcare Imprvement in partnership w ith American Hspital Assciatin and Cathlic Health Assciatin f the United States

2 Cntents What Are Age-Friendly Health Systems and Why Are They Imprtant? 3 The 4Ms Framewrk f Age-Friendly Care 3 Jin Us: Age-Friendly Health Systems Actin Cmmunity 5 Actin Cmmunity Schedule f Activities 6 What Are the Benefits f Participating? 6 What Is the Cst t Participate? 7 Hw D We Jin the Age-Friendly Health Systems Actin Cmmunity? 7 Partners 8 IHI Team 8 Advisry Grup 9 References 10 Institute fr Healthcare Imprvement ihi.rg 2

3 What Are Age-Friendly Health Systems and Why Are They Imprtant? Three factrs that impact caring fr lder adults in the United States tday are ccurring simultaneusly. Tgether the factrs make a cmpelling case fr health systems t better supprt the needs f lder adults and caregivers: Demgraphy: The number f adults ver the age f 65 is prjected t duble ver the next 25 years. 1 Cmplexity: Apprximately 80 percent f lder adults have at least ne chrnic disease, and 77 percent have at least tw. 2 Many f ur health systems are illequipped t deal with the scial cmplexity many lder adults face. 3 Disprprtinate Harm: Older adults have higher rates f health care utilizatin as cmpared t ther age grups and experience higher rates f health care-related harm, delay, and discrdinatin. One cnsequence f this is a rate f ED utilizatin that is fur times that f yunger ppulatins. 4 Becming an Age-Friendly Health System entails reliably prviding a set f specific, evidencebased geriatric best practice interventins t all lder adults in yur health system. This is achieved primarily thrugh redeplying existing health system resurces t achieve: Better health utcmes fr this ppulatin; Reduced waste assciated with lw-quality services; Increased utilizatin f cst-effective services fr lder adults; and Imprved reputatin and market share with a rapidly grwing ppulatin f lder adults. The 4Ms Framewrk f Age-Friendly Care In 2017, The Jhn A. Hartfrd Fundatin and the Institute fr Healthcare Imprvement (IHI), in partnership with the American Hspital Assciatin (AHA) and the Cathlic Health Assciatin f the United States (CHA), set the bld aim that 20 percent f US hspitals and health systems wuld be Age-Friendly Health Systems by June 30, Five prttyping health systems, Anne Arundel Medical Center, Ascensin, Kaiser Permanente, Prvidence St. Jseph Health, and Trinity, stepped frward t learn what it takes t be an Age-Friendly Health System. The 4Ms Framewrk fr Age-Friendly Care that emerged is bth evidence based and able t be put int practice reliably in the health care setting. The 4Ms are: What Matters, Medicatins, Mentatin, and Mbility. Institute fr Healthcare Imprvement ihi.rg 3

4 What Matters: Knw and align care with each lder adult s specific health utcme gals and care preferences including, but nt limited t end-f-life, and acrss settings f care. Medicatin: If medicatin is necessary, use Age-Friendly medicatins that d nt interfere with What Matters t the lder adult, Mbility, r Mentatin acrss settings f care. Mentatin: Prevent, identify, treat, and manage dementia, depressin, and delirium acrss care settings. 6 Mbility: Ensure that lder adults mve safely every day in rder t maintain functin and d What Matters. These 4Ms are the essential elements f high-quality care fr lder adults and, when implemented tgether, indicate a brad shift by health systems t fcus n the needs f lder adults. Reliable implementatin f the 4Ms is supprted by bard and executive cmmitment t becming an Age- Friendly Health System, lder adult and caregiver engagement, and cmmunity partnerships. Institute fr Healthcare Imprvement ihi.rg 4

5 Jin Us: Age-Friendly Health Systems Actin Cmmunity IHI has a well-established track recrd, based n years f experience, f cnvening like-minded rganizatins in cmmunities t rapidly scale-up slutins t vexing prblems in health care, including readmissins, deplying the Triple Aim, and achieving system-wide excellence. In September f 2018, 124 teams frm 70 rganizatins jined the first Age-Friendly Health Systems Actin Cmmunity t imprve care fr lder adults. The first Actin Cmmunity cncluded in March The next Age-Friendly Health Systems Actin Cmmunity will take place frm April Octber The Actin Cmmunity is designed as an n-ramp fr hspital-based teams (e.g., emergency departments, ICUs, general wards, medical-surgical units) and ambulatry care teams (e.g., primary care, specialty care) t test and adpt the 4Ms. The instructin and caching is setting specific and include transitins in care between settings. April Octber 2019 Institute fr Healthcare Imprvement ihi.rg 5

6 Actin Cmmunity Schedule f Activities January March 2019 April Octber 2019 Teams Enrll in the April Octber 2019 Actin Cmmunity Participate in ne Getting Started webinar March 25, :00 4:00 pm ET April 1, :30-3:30 pm ET Cmplete the Getting Started Guide Cmplete ne prcess-walk t bserve delivery f care in actin Share with us a letter demnstrating the health sy stem, hspital, r practice leadership supprt f the team with time, resurces, and barrier remval s the team may actively participate in all prgram activities Check feasibility f data cllectin and establish data capture prcess Meet with three lder adults t ask them What Matters? mst t them Leaders Participate in ne Getting Started webinar Teams Submit mnthly qualitative and quantitative reprts fr utcme and prcess measures Attend mnthly Team Webinars Tw drp-in caching calls each mnth: Measurement supprt, testing supprt Leaders Participate in mnthly Leaders and Spnsrs Webinars What Are the Benefits f Participating? At the end f the seven-mnth Actin Cmmunity, the participating rganizatins will have implemented the specific changes f the Age-Friendly Health Systems 4Ms Framewrk in their unit, clinic, ED, r prgram, and will have early data n key measures that demnstrate initial evidence f benefit t the lder adults that they serve. The rganizatins will als be natinal leaders as rganizatins n their way t becming Age- Friendly Health Systems. Institute fr Healthcare Imprvement ihi.rg 6

7 What Is the Cst t Participate? There is n fee t participate in the Age-Friendly Health Systems Actin Cmmunity. A health sy stem, hspital, r practice in the US can enrll as many sites/teams as it wuld like t participate in the Actin Cmmunity (e.g., a hspital may elect t enrll tw ICU teams, an ED team, and five general medical unit teams). It has been IHI s experience that rganizatins that enrll multiple teams accelerate their pace f transfrmatin. The cst f participatin includes the time teams must allcate t engage in Actin Cmmunity activities listed abve (e.g., webinars and calls, data cllectin and measurement), test the specific changes in their daily wrk, and reprt n prgress in between calls. Each participating rganizatin will build its wn team. The Actin Cmmunity testing and learning is designed t ccur as part f each persn s existing activities and is, therefre, a repurpsing f time rather than incrementally additinal time. Fr example, a hspital r practice will generate and review quality reprts as part f standard wrk. As part f the Age-Friendly Health Systems Actin Cmmunity, certain quality indicatrs may be segmented by age. Testing f specific Age-Friendly changes by clinicians will ccur as part f standard clinical activities. Based n IHI s experience, teams that include access t the fllwing resurces are ften mre successful: An lder adult and caregiver are cre members f the team; A spnsr wh can authrize and supprt team activities and participate in the leadership chrt; Clinicians wh represent the disciplines invlved in the 4Ms (this will be specific t y ur cntext, but may include a physician, nurse, physical therapist, scial wrker, pharmacist, and thers that represent the 4Ms in yur cntext); A lcal leader wh is vested in quality imprvement methds and tls and has authrity t design and lead imprvement tests; An imprvement cach; A data analyst; and A finance representative. Hw D We Jin the Age-Friendly Health Systems Actin Cmmunity? Fr further infrmatin abut the Actin Cmmunity, jin ne f ur free infrmatinal calls: January 30, 2019 (12:00 1:00 PM ET) - Register fr the meeting here. March 6, 2019 (2:00 3:00 PM ET) - Register fr the meeting here. Befre the Actin Cmmunity begins in April 2019, interested teams will be asked t: Institute fr Healthcare Imprvement ihi.rg 7

8 Identify a clinical care setting and patient ppulatin t test the 4Ms; Bring tgether an interdisciplinary team; Identify a leader with authrity ver the selected care setting r ppulatin t supprt the team s activities and prgress and participate in the leadership track; Participate in Actin Cmmunity activities including sharing data with IHI. If y u are ready t enrll sites in the Actin Cmmunity, yu can d s here. Please cnsider: Partners Engaging a diverse team that reflects yur lder adult cmmunity; and Demnstrating prir experience with using a quality imprvement methdlgy (e.g., Mdel fr Imprvement, LEAN, Six Sigma) and managing imprvement prjects and teams. Age-Friendly Health Systems is an initiative f The Jhn A. Hartfrd Fundatin and the Institute fr Healthcare Imprvement (IHI) in partnership with the American Hspital Assciatin (AHA) and the Cathlic Health Assciatin f the United States (CHA). The Actin Cmmunity als draws n the expertise f the Advisry Grup and faculty experts in the 4Ms subject matter, testing and scale-up methdlgy, and rganizatinal psychlgy. A full list f faculty can be fund n IHI Team Kedar Mate, MD Chief Innvatin and Educatin Officer Leslie Peltn, MPA Senir Directr Karen Baldza, MSW Executive Directr, Imprvement Advisr Kev in Little, PhD IHI Faculty, Imprvement Advisr KellyAnne Jhnsn, MPH Senir Prject Manager Tam Dung, MSPH Senir Prject Manager & Research Assciate Kim Mitchell, MS Prject Manager Allisn Luke Prject Crdinatr Institute fr Healthcare Imprvement ihi.rg 8

9 Advisry Grup Ann Hendrich, PhD, RN, FAAN Mary Tinetti, MD Ky le Allen, DO, AGSF Antni Beltran Dn Berwick, MD, MPP, FRCP Jay Bhatt, DO Alice Bnner, PhD, RN Peg Bradke, RN, MA Nicle Brandt, PharmD, MBA, BCGP, BCPP Jim Cnway, MS Dnna Fick Ph.D., RN, FGSA, FAAN Terry Fulmer, PhD, RN, FAAN Kate Gdrich, MD Ann Hwang, MD Maulik Jshi, DrPH Dug Kekkek, MD Lucian Leape, MD Marty (Martha) Leape Senir Vice President and Chief Quality/Safety and Nursing Officer, Ascensin (Advisry Grup c-chair) Gladys Phillips Crft Prfessr f Medicine (Geriatrics); Prfessr, Institutin fr Scial and Plicy Studies; Sectin Chief, Geriatrics (Advisry Grup c-chair) Vice President Enterprise Medical Directr fr CareSurce Vice President, Safety Net Transfrmatin, Trinity Health President Emeritus and Senir Fellw, Institute fr Healthcare Imprvement; Frmer Administratr f the Centers fr Medicare & Medicaid Services Chief Medical Officer, President and CEO, Health Research and Educatinal Trust and American Hspital Assciatin Secretary, Executive Office f Elder Affairs, Cmmnwealth f Massachusetts Vice President, Pst-Acute Care, UnityPint Health St. Luke s Hspital Prfessr, Department f Pharmacy Practice and Science, University f Maryland Schl f Pharmacy; Executive Directr, Peter Lamy Center n Drug Therapy and Aging Adjunct Lecturer, Harvard Schl f Public Health; Senir Cnsultant, Safe and Reliable Healthcare Eluise Rss Eberly Prfessr f Nursing and Prfessr f Medicine and Directr, Center f Geriatric Nursing Excellence at Pennsylvania State University; Editr, Jurnal f Gerntlgical Nursing President, Jhn A Hartfrd Fundatin Directr, Center fr Clinical Standards and Quality, and Chief Medical Officer, Centers fr Medicare & Medicaid Services Directr f the Center fr Cnsumer Engagement in Health Innvatin, Cmmunity Catalyst Executive Vice President f Integrated Care Delivery and Chief Operating Officer, Anne Arundel Health System Chief Executive, Prvidence Medical Grup Adjunct Prfessr f Health Plicy, Harvard Schl f Public Health (retired) Frmer Directr f the Office f Career Services, Harvard Cllege Institute fr Healthcare Imprvement ihi.rg 9

10 Bruce Leff, MD Becky Margitta VJ Periyakil, MD Eric Rackw, MD Nirav Shah, MD, MPH Albert Siu, MD Steve Stein, MD Julie Trcchi Prfessr, Jhns Hpkins Medicine; Directr, The Center fr Transfrmative Geriatric Research CEO and President, The Billins Institute, LLC Directr, Palliative Care Educatin and Training, Stanfrd University Schl f Medicine; VA Pal Alt Health Care System, Divisin f Primary Care and Ppulatin Health President, Humana At Hme; President Emeritus, NYU Hspital Center; Prfessr f Medicine, NYU Schl f Medicine Adjunct Prfessr at the Schl f Medicine, Stanfrd University Prfessr and System Chair, Geriatrics and Palliative Medicine, Ppulatin Health Science and Plicy, General Internal Medicine Chief Medical Officer, Trinity Health Cntinuing Care Grup Senir Directr, Cmmunity Benefit and Cntinuing Care, Cathlic Health Assciatin f the United States References 1 The State f Aging and Health in America Atlanta: Centers fr Disease Cntrl and Preventin, US Department f Health and Human Services; Fact Sheet: Healthy Aging. Natinal Cuncil n Aging; Abrams M, Milstein A. NAM Wrkshp Series n High-Need Patients. Natinal Academy f Medicine; Octber Institute f Medicine Cmmittee n the Future Health Care Wrkfrce fr Older Americans. Retling fr an Aging America: Building the Health Care Wrkfrce. Washingtn, DC: Natinal Academies Press; , Health Status and Health Care Service Utilizatin. 5 Age-Friendly Health Systems initiative. Health-Systems/Pages/default.aspx 6 Fulmer T, Mate KS, Berman A. The Age-Friendly Health System imperative. J Am Geriatr Sc Jan;66(1): di: /jgs Institute fr Healthcare Imprvement ihi.rg 10