Use of a nursing-led geriatrics consult service to deliver age-friendly care

Abstract

The Elder Veteran Program (EVP) is a nursing-led approach to deliver inpatient consultative geriatrics care at our academic Midwestern Veterans Hospital. From April to December of 2021, EVP modified its workflow using a Plan-Do-Study-Act approach to include previously under-addressed components of the IHI's "4M's" of Age-Friendly Care (Medication, Mobility, Mentation, and What Matters), with three months of retrospective data review as a Plan phase, three months of monthly Do and Study phases, and a three month Act phase to analyze post-intervention care. We found improvements in frequency of documentation of Medication, Mentation, and What Matters in EVP notes, and maintenance of Mobility documentation. Next steps include translating these documentation and workflow changes into other relevant outcome measures and outreach to other departments. Overall, our project demonstrates a novel way to integrate these Pillars into a hospital system, by leveraging an existing nursing-led geriatric consult service focused on prevention and education.

Keywords: Acute care; Advance care planning; Age friendly care; Delirium; Geriatrics; Quality improvement.