UCI Medical Center designated age-friendly health system | UCI Health


Age-friendly Health Systems badge 2021



June 04, 2021

 

UCI Medical Center has been awarded the highest designation for excellence in caring for older hospitalized patients from the Institute for Healthcare Improvement (IHI).

The recent Level 2 designation of the Inpatient Care Unit as an Age-Friendly Health System — Committed to Care Excellence, follows IHI’s earlier Level 2 designation of UCI Health outpatient primary care services and Level 1 designation of the Emergency Department for their commitment to healthcare excellence for older adults. The emergency department is expected to achieve Level 2 designation later this year.

“This designation for UCI Health is exciting because it shows we demonstrate a commitment to the highest level of care for seniors,” says Dr. Lisa Gibbs, professor and chief of the UCI School of Medicine’s Division of Geriatric Medicine & Gerontology and director of the UCI Health SeniorHealth Center.

“It means we are focused on providing a continuum of age-friendly care for patients in all our clinical settings, including the outpatient, inpatient and emergency room sites of care.”

The UCI Health geriatric medicine program is regularly recognized among the top 50 in the country in annual best hospitals rankings by U.S. News & World Report. The SeniorHealth Center was among the country’s first patient-centered medical homes for geriatric care and a Center of Excellence in Elder Abuse. And the Division of Geriatric Medicine & Gerontology has long been an advocate for improving the health of older adults, training future physicians to meet the needs of this growing population.

The number of people age 65 and older is projected to nearly double in 30 years — from 43 million in 2012 to an estimated 83 million in 2050, according to U.S. Census data. Along with this increased life expectancy, the population of older adults with multiple chronic conditions is projected to rise, posing challenges for the nation’s healthcare systems.

To receive the IHI designation, all three UCI Health units screened and assessed patients who were age 65 and older using evidence-based criteria. This data along with action plans for care were submitted to IHI, which approved the plans and designated the programs as Age-Friendly Health System Participants (Level 1).

Next, the UCI Health units gathered and submitted three additional months of data on patients who received age-friendly care. Level 2 status as an Age-Friendly Health System is granted once IHI reviews and approves the action plans’ implementation.

What is an age-friendly health system?

The IHI, an independent nonprofit organization dedicated to improving healthcare practices, defines an age-friendly health system as one in which every older adult’s care is guided by an essential set of evidence-based practices called the 4Ms to organize care with a focus on an older adult’s wellness and strengths rather than solely on a disease. They include:

  • What Matters: This is the most important “M,” which seeks to align care with what matters most to older adults. Providers ask each patient to identity what matters most to them in their life and health, and what they want from their healthcare.
  • Medication: This includes the prevention of polypharmacy, or too many medications, which can increase the risk of side effects as well as drug interactions that affect cognition and memory, fall risk, insomnia and many other conditions..
  • Mentation (mental activity): Providers monitor patients to prevent, identify and treat any symptoms of dementia, depression or delirium across care settings.
  • Mobility: Providers strive to ensure that older adults are able to move safely in order to maintain daily function and to be able to do what matters most in their lives.

Age-friendly healthcare systems also must cause no harm to patients and must provide care that is consistent with what matters to the older adult and his or her family.

The 4Ms also increase patient satisfaction and lead to better health outcomes, resulting in lower costs for patients and increased cost-effectiveness for hospitals and healthcare practices, according to IHI.

The 4Ms in practice

If you could change one aspect of your healthcare, what would it be?

“This is one of the most important questions we ask an older patient during an annual wellness visit,” says Gibbs. It’s a question that prompts a discussion about what matters most to each patient and helps the provider outline realistic healthcare goals.

“The answer can be as simple as a patient wanting to be able to walk their dog again because it brings them joy,” she adds.

Together, the patient and provider can then develop a plan for managing the patient’s arthritis so that she can walk her dog for 10 minutes a day. It may also mean reviewing medications to ensure that they are age-friendly and don’t interfere with the patient’s mobility or cause cognitive impairment.

Evidence shows that when you include patients, their families and caregivers in healthcare decisions, it’s more likely that their healthcare goals will be met, Gibbs says.

Commitment to senior care

These values are part of the DNA of the UCI Health SeniorHealth Center, which offers a wide range of services to meet the needs of aging adults and their families, including:

  • Primary care designed specifically for adults age 60 and older. Physicians provide preventive healthcare and treatment for acute and chronic illness. Patients can meet with a geriatrician for ongoing care or a consultation about specific health concerns.
  • Specialized care for geriatric syndromes such as memory loss, falls, frailty, urinary incontinence or functional decline.
  • Specialty services, including:
    • Health Assessment Program for Seniors (HAPS), a comprehensive assessment for older adults with complex health concerns. A multidisciplinary team reviews the assessment results and assembles an individualized plan of support for the patient and their caregivers.
    • Memory Assessment services. For some individuals, minor issues such as misplacing items can just be annoying, but for others memory problems may interfere with daily living. Early identification of dementia is important for optimal health and welfare. The memory assessment team works to identify and address memory complaints and contributing factors.
    • Falls assessment services. For those who have experience falls, or at risk for failing, the falls clinic evaluates what places individuals at risk and makes recommendations for optimal health and falls prevention.
    • Geriatric oncology assessments. For those who are undergoing treatment for cancer, our team reviews issues such as medications and side effects, maintaining function, quality of life, optimizing health and advance care planning.

There is a national shortage of geriatricians and other healthcare providers specializing in the care of older adults, which is why the Division of Geriatric Medicine & Gerontology is committed to building a future healthcare workforce so that older adults receive the care they deserve. The Geriatric Workforce Enhancement Program (GWEP) provides training to healthcare workers that helps maximize geriatric patient and family engagement. The program, funded by a grant from the U.S. Health Resources and Services Administration (HRSA), also seeks to integrate geriatric medicine into primary care practice.

Two GWEP initiatives have already emerged:

  • A mobile-friendly dementia care website for healthcare practitioners developed by UCI Health geriatric medicine specialists led by Dr. Steven Tam in partnership with Alzheimer’s Orange County.
  • Free, virtual geriatric education classes for healthcare professionals that also provide continuing medical education credits. The most recent series covered mental and emotional issues facing older adults. A new series beginning June 11, 2021, will address “Chronic Diseases in Older Adults.”

”All our programs promote clinical excellence and the advancement of care for seniors,” says Gibbs. ”The future of healthcare for seniors depends on innovations such as team-based care, telehealth and remote patient monitoring, as well as a unique understanding of the transitions in later years that affect health and well being. We aim to promote optimal living and empowered longevity.”

For more information about the geriatric medicine classes, contact [email protected].

The UCI Health system is the clinical enterprise of the University of California, Irvine. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, California. The 418-bed acute care hospital, listed among America’s Best Hospitals by U.S. News & World Report for the 20th consecutive year, provides tertiary and quaternary care, ambulatory and specialty medical clinics, and behavioral health and rehabilitation services. UCI Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook and Twitter.




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