Primary Care Clinics

Written by Robin Arnold, Clinical Quality Improvement Analyst, Deaconess Clinic

Deaconess Hospital and the University of Southern Indiana partner to provide innovative care models and education for the geriatric population to support the aging process. According to the U.S. Census Bureau, the 65+ population will nearly double over the next 30 years from 43.1 million in 2012 to an astounding 83.7 million in 2050. Aging is a normal process as we navigate life, and health systems need to provide reliable evidence-based care to every older adult at every interaction. One of the objectives of this partnership is to transform primary care settings to become part of an age-friendly health system, which is a national effort with the Indiana Hospital Association. 

In a unique partnership, Deaconess and USI are working in three primary care clinics to adopt Age-Friendly Health System practices. The Age-Friendly Health System initiative is a national effort supported through the Institute of Healthcare Improvement. Within this model, providers and staff function within the area of four evidence-based elements of high-quality care known as the 4Ms – what Matters, Medication, Mentation, and Mobility. 

• What Matters: Know and align care with each older adult’s specific health outcome goals and care preferences including, but not limited to, end-of-life care. Providers work with patients to complete advance directives aligned to what matters when they are no longer able to make medical decisions on their own. 
• Medication: If medication is necessary, use age-friendly medication that does not interfere with What Matters to the older adult, Mobility or Mentation across settings of care. Providers will work with patients to screen for any high-risk medications to eliminate risk. 
• Mentation: Prevent, identify, treat and manage delirium across settings of care. Providers identify patients with dementia and work with their caregivers to provide resources and education. 
• Mobility: Ensure that each older adult moves safely every day to maintain function and do What Matters. Providers screen patients to identify any fall risks and work to ensure their homes are safe to mitigate falls. 

Deaconess has appointed a provider in each of the three clinics to champion the framework and advocate for a care model centered on the 4Ms.  A geriatrician leads the initiative and works directly with each provider to review clinical workflows related to the 4Ms, co-deliver 4Ms provider education and identify process challenges and solutions to resolve. This cross-functional collaboration cultivates a health system that aligns to the aging process. These efforts have led to age-friendly recognition from the Institute of Healthcare Improvement.  USI and Deaconess continue to work on these efforts. 

Learn more about our age friendly clinics.