SHM Converge Scientific Abstract ePoster Gallery-Providing Age-Friendly Care

Pdf Summary

This document describes a retrospective chart review evaluating whether Mount Sinai’s Hospitalization at Home (HaH) program provides age-friendly care using the 4Ms framework: What Matters, Medication, Mentation, and Mobility.<br /><br />The 4Ms framework is an age-friendly model intended to align care with patients’ goals, ensure safe medication use, monitor cognitive status, and assess mobility. HaH offers inpatient-level treatment in the patient’s home, which may be especially beneficial for older adults in a fragmented healthcare system where errors are common.<br /><br />Researchers reviewed 50 randomly selected HaH admissions from December 2023 to December 2024; one patient was excluded after rapid escalation. The average patient age was 70, average length of stay was 4.7 days, 73% were female, 30% preferred a non-English language, 35% lived alone, 49% had a home health aide, and 50% had Medicaid coverage, suggesting a racially and economically diverse population.<br /><br />Key findings showed that all reviewed admissions had at least one documented element in each of the 4M domains. For “What Matters,” code status was documented in 100% of patients, a health care proxy/surrogate in 69%, family or friends were involved in care in 75%, and goals-of-care discussions were documented in 29%. For medications, medication reconciliation occurred in 100%, discrepancies were found in 41%, clinically significant discrepancies in 30%, and unintentional discrepancies in 12%. For mentation, mental status assessments were documented in 100%. For mobility, functional assessments were documented in 100%, while PT/OT evaluations occurred in 39%.<br /><br />Overall, the study concludes that the HaH model consistently fulfills the 4Ms framework and appears to provide age-friendly, patient-centered care. The authors note that CMS will begin requiring hospitals to report these elements in 2025, and further research is needed to ensure age-friendly care across the full medical journey.

Asset Subtitle

Jeffrey D. Epstein

Meta Tag

Author List Helena Zeleke, Irina Zaretsky, Jeffrey D. Epstein, Kathryn Cole, Tuyet-Trinh Truong

Category Research

Concept 4Ms

Concept Medication

Concept Mobility

Concept Home-Based Acute Care

Concept Retrospective Chart Review

Distinguished Non-Finalist

Presenter Organization Division of Hospital Medicine, Mount Sinai Hospital

Presenting Author Jeffrey D. Epstein

Track Geriatrics

Keywords

Hospitalization at Home

HaH

4Ms framework

age-friendly care

retrospective chart review

older adults

medication reconciliation

goals of care

mental status assessment

mobility assessment

4Ms

Medication

Mobility

Home-Based Acute Care

Retrospective Chart Review