As the baby boomer generation ages, health systems face the challenge of providing adequate care to this growing demographic.
By 2050, the 65-and-older population is projected to reach nearly 84 million. That's nearly double the 2012 number of 43.1 million, according to the Census Bureau.
The John A. Hartford Foundation, Institute for Healthcare Improvement and the American Hospital Association, along with other partners, have launched an Age-Friendly Health Systems initiative to meet the complex needs of aging adults.
“People are getting older and they’re living longer,” says Kedar Mate, M.D., chief education and innovation officer, IHI, and principal investigator of the initiative. “We have to get better at providing care for them.”
The initiative is funded by a $3.19 million grant spanning 42 months from the John A. Hartford Foundation to develop and test evidence-based, health systemwide prototype models of care for older adults. Its goal is to spread the Age-Friendly Health Systems model to 20 percent of hospitals and health systems in the U.S. by 2020.
“We’re leading a movement, really, to reimagine what the 21st century health system can look like,” says Terry Fulmer, R.N., president of the John A. Hartford Foundation, New York City.
The partners drew from the knowledge of top geriatric experts and evidence-based elements from 20 age-friendly models sponsored by Hartford to form the heart of the new age-friendly model.
They are the four Ms, as Mate describes them, which include: medication (getting medicines right, reviewing the medication, de-escalating therapy and looking at medications as a whole as a big risk area), mobility (getting people up, keeping them moving to make sure they can perform activities for independence and prevent functional decline), mentation (Improving care for patients with depression, dementia and delirium) and what matters. The last is considered top priority because, as Mate says, “unless we know what matters to older people, we cannot do what matters for older people.”
The first year of the grant will be dedicated to working within small-scale clinical settings to streamline and simplify age-friendly models and eventually scale up to the size of the four systems involved initially: Kaiser Permanente, Oakland, Calif.; Trinity Health System, Livonia, Mich.; Providence St. Joseph Health, in seven Pacific, Mountain and Great Plains states; and Anne Arundel Medical Center, Annapolis, Md.
With the goal of implementing the new age-friendly model in 1,000 care sites by 2020, one of the biggest challenges will be to establish a culture focused on this new approach.
Jay Bhatt, D.O., chief medical officer of the AHA and president of the AHA’s Health Research & Educational Trust and geriatrician, says health care leaders need to think about the importance of the continuum of care and value-based models as they move toward age-friendly care.
“Instead of a system in which volume defines success, we’re saying this new system is really based on high-reliability organizations, leadership, a safety culture and better outcomes at lower costs,” says Bhatt.