The John A. Hartford Foundation has teamed up with the Institute for Healthcare Improvement to develop an Age-Friendly Health Systems model with the goal of ensuring that older adults receive optimal care across health care settings. In partnership with the American Hospital Association and the Catholic Health Association of the United States, they are aiming to promote and spread this model of care to 20% of U.S. hospitals and health systems by 2020.

Patient Marjorie Orrin, assisted by patient care assistant (now RN) Jessica Barton (left) and physical therapist Hannah Cavicchio, participates in the MOVE program-Mobility Enhances Virtually Everything-created by St. Mary Mercy Livonia Hospital in Livonia, Michigan, as part of the Age-Friendly Health Systems initiative. Orrin's shorts display the MOVE logo. Photo courtesy of the Saint Joseph Mercy Health System.

Hartford Foundation president Terry Fulmer described her vision of an age-friendly health system as one "that starts at your kitchen table, brings you through whatever care team you need-emergency room, long-term care, critical care-and gets you back to your kitchen table in a way that addresses your needs and takes into account what's important to you."

Participating systems will initially focus on four interventions, dubbed "the 4Ms": What Matters ("Understand and actively support what matters to older adults"), Medication ("Discuss whether medications are unnecessary or potentially harmful"), Mobility ("Review mobility plans for each patient"), and Mentation ("Improve mentation by addressing problems like dementia, delirium, and depression").

"These four elements interact all day long in the lives of older people," Fulmer told AJN. For example, if older adults are not taking the correct medications, their mentation and mobility "will likely be off as well," Fulmer said. "If we're not dealing with what matters to you, you certainly become depressed and may not eat as well." She added that because nurses are ever-present in health care settings, "nurses are the backbone to an age-friendly health system."

Testing of the model has been underway at five large health systems, and the organizations are now actively seeking 100 teams from other health systems across the United States to be part of what they are calling the Age-Friendly Health Systems Active Community. More information on the initiative and how to participate is available at http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Pages/default..-Elizabeth Mechcatie, MA, BSN