Age-Friendly Spotlight: Sparrow Ionia Hospital

Learn how healthcare systems are innovating to address the unique needs of older adults through the MHA Keystone Center’s Age-Friendly Health Systems Action Community.

Located in Ionia, Michigan, Sparrow Ionia Hospital is a 22-bed critical access hospital whose patients ages 65 and older represent half of all admitted patients. The hospital has remained committed to quality and safety and has worked tirelessly to improve care practices for older adult patients since joining the MHA Keystone Center Age-Friendly Health Systems Action Community in 2019.

The hospital is nationally recognized as an Age-Friendly Health System Committed to Care Excellence by the Institute for Healthcare Improvement (IHI) for working to create an age-friendly environment for patients. Steven Dexter, medical-surgical unit and special care manager, Sparrow Ionia Hospital, shares insight into the hospital’s age-friendly journey below.

What is an Age-Friendly Health System?

Becoming an Age-Friendly Health System entails reliably providing a set of four evidence-based elements of high-quality care, known as the “4Ms,” to all older adults: What Matters, Medication, Mentation and Mobility.


The IHI recognizes clinical care settings that are working toward reliable implementation of the 4Ms. As of May 2021, nearly 2,100 healthcare organizations have earned either level 1 (Participant) or level 2 (Committed to Care Excellence) recognition in the Age-Friendly Health Systems movement.

  • Level 1 (Participant) teams have successfully developed plans to implement the 4Ms.​
  • Level 2 (Committed to Care Excellence) teams have three months of verified data to demonstrate early impact of using the 4Ms.

Steven Dexter, medical-surgical unit and special care manager, Sparrow Ionia Hospital, shares insight into the hospital’s age-friendly journey in the following sections below.

Photographed left to right: Lisa Harris, Interim CNO; Sally Fox, House Supervisor Mary Whitelock, clinical nurse educator; Steven Dexter, medical-surgical and special care unit manager; and Mary Ziegler, house supervisor.

Why did you join the Age-Friendly Health Systems Action Community?

The need for special focus on older patients is obvious. Currently, more than half of all patients at Sparrow Ionia are age 65 and older, and that is expected to soar throughout the nation because of the baby-boom generation. Sparrow Ionia recognized the need to change the traditional model of care delivery to improve the care delivered to the growing population of older patients. With the MHA Keystone Center’s support, we can focus on what matters to older adult patients rather than only what’s the matter with them.

How has joining this national movement improved and impacted the way you care for older adults?

The impact of our work has resulted in awareness to caregivers that can help institute the 4M framework and intentionally individualize care to that type of patient. Hence, patients find value in the care received. Awareness is what makes the biggest impact, so we spread daily awareness by reporting the percentage of age-friendly patients who are on our inpatient unit.

As part of the Age-Friendly 4M framework of “what matters,” the caregivers at Sparrow Ionia Hospital ask our older patients certain questions. An example of a “what matters” question we use is, “What is one thing everyone should know that matters to you while you are here?” One patient told me that he had been in the war and was scared and alone at that time and now, even though he is older and wiser, he sometimes feels that same way. I reassured him that all the caregivers were there for him and thanked him for his ultimate service.

The medical-surgical caregivers brainstormed a way to recognize the heroes who served our county and thank them for their service while they are in the hospital. As a result, small American flags are now put outside the door of those patients’ rooms, so all caregivers can recognize and thank our patients who are veterans.

Another conscious thing we do to promote age-friendly care is we use small, yellow “4M” door signs to reveal an age-friendly patient so that every caregiver can know that a patient has something that matters to them. In addition to the signs, we elevate the “what matters” answer by discussing them in the daily multidisciplinary rounds so that care can be patient-centered. The answer is charted in the EMR “sticky note” summary front page of the chart.

In addition to these impactful stories, we have seen an increase in patient satisfaction. Patients verbalize the feeling of being cared for and how happy they are with the care they receive at Sparrow Ionia Hospital.

What is one thing you would like to share with a healthcare organization interested in becoming an Age-Friendly Health System?

Age-Friendly is a foundation that most of us use every day with the care we provide. The great thing about this 4M framework is that it can be used for any age group, resulting in intentional, individualized care that patients will see, hear and feel.