As New York state’s aging population increases, older adults face challenges accessing healthcare while hospitals struggle to meet their growing needs. Older patients are admitted at higher rates and acuity levels than younger patients and often present as distressed and disoriented during their hospital stay. In November 2020, Saratoga Hospital joined the New York State Age-Friendly Action Community to address these and other challenges for older adults.
At Saratoga Hospital, more than 55% of patients are at least 65 years old and nearly one-third are 75 or older. After joining the Action Community, they began reviewing hospital practices and aligning them with the four evidence-based elements of high-quality care for older adults. Known as the 4Ms, these elements include What Matters, Medication, Mentation and Mobility. Healthcare facilities that have adopted the 4Ms framework report improved safety and quality outcomes and patient experience for older adults. Because the 4Ms framework helps enhance quality of care, adopting the 4Ms model can also help prevent adverse effects and the resulting additional expenses.
To deliver on the 4Ms, Saratoga Hospital engaged providers and departments from throughout the organization — nurses, physicians and advanced practice providers; physical, occupational and speech therapists; recreational therapists, volunteers and representatives from palliative care, pharmacy, care management, food and nutrition services and other service lines.
The multidisciplinary team identified opportunities to adopt 4Ms practices and tested various interventions with older adults across the hospital. Examples include: medication reconciliation upon admission, asking “what matters” questions every 12 hours and aligning care accordingly, and performing delirium (NuDESC) and Johns Hopkins Highest Level of Mobility assessments every 12 hours. Saratoga Hospital tracked efforts and outcomes, submitted data to the Institute for Healthcare Improvement and in July, IHI recognized the organization as an Age-Friendly Health System — Committed to Care Excellence.
Learn more about HANYS' involvement in the New York State Action Community.