SHM Converge Scientific Abstract ePoster Gallery-Age-Friendly Initiative: Outcomes From an Acute Care for Elders Unit

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This study examined whether greater delivery of the age-friendly hospital “4M” framework—What Matters Most, Medications, Mentation, and Mobility—was linked to fewer discharges to new post-acute care among older adults hospitalized on Vanderbilt’s Acute Care for Elders (ACE) unit.<br /><br />Researchers conducted a prospective cohort study of patients age 65 and older admitted to the geriatric medicine service from April to December 2021. After exclusions, 430 participants were included. The team used electronic medical record documentation to score each of the 4Ms from 0 to 3 points, for a total possible score of 0 to 12. The main outcome was discharge to a new post-acute care setting.<br /><br />Participants had a median age of 80, and 56% were female. The median total 4M score was 7, suggesting moderate exposure to the framework. About 42% of patients (179/430) were discharged to new post-acute care.<br /><br />Results did not show a protective association between higher 4M exposure and reduced discharge to post-acute care. In both unadjusted and adjusted logistic regression models, neither individual M nor the total 4M score was significantly associated with the outcome. For the total 4M score, the adjusted odds ratio was 1.04 (95% CI 0.94–1.14).<br /><br />The authors concluded that while measuring 4M delivery through the electronic medical record is feasible, this study did not demonstrate improved discharge outcomes from greater 4M exposure. They note important limitations, including the lack of a gold standard for measuring each M, uncertainty about the “dose” needed to affect outcomes, and the possibility that different Ms may influence outcomes differently. Future work should evaluate proximal outcomes, validate EMR-based measurement with observation or interviews, and improve reliability of 4M measurement.

Asset Subtitle

Sarah a Welch

Meta Tag

Author List Christianne L. Roumie, Maria C. Duggan, Sarah a Welch

Category Research

Concept CMS 4Ms Age-Friendly Care Framework

Concept 4Ms

Concept Medications

Concept Mobility

Concept 4M Care Exposure

Distinguished Non-Finalist

Presenter Organization VA Tennessee Valley Healthcare System, Vanderbilt Department of Physical Medicine and Rehabilitation

Presenting Author Sarah a Welch

Track Geriatrics

Keywords

age-friendly hospital

4M framework

older adults

post-acute care

acute care for elders

prospective cohort study

electronic medical record

discharge outcomes

geriatric medicine

hospitalization

CMS 4Ms Age-Friendly Care Framework

4Ms

Medications

Mobility

4M Care Exposure