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.

Recognition

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.

Survey Assesses Need for Older Adult Care Support

As a patient safety and quality organization committed to better outcomes, the MHA Keystone Center is dedicated to supporting health systems across Michigan in becoming age friendly. By adopting evidence-based models and delivery care practices that meet the needs and preferences of older adults, the healthcare system and communities can improve care across the continuum of life.

Members are encouraged to take the MHA Keystone Center’s brief survey to assess health systems’ interests and needs for support around improving care for older adults. This survey will determine priorities and help shape and guide the MHA Keystone Center’s future older-adult care offerings.

Members with questions may contact the MHA Keystone Center.

Annual Report Highlights Member Dedication Amid COVID-19

2020-2021 Annual Report

2020-2021 Annual ReportThe MHA Keystone Center recently released its 2020-2021 Annual Report, which showcases the center’s accomplishments and member-driven efforts to improve the quality and safety of healthcare statewide and beyond. It also describes member hospitals’ connection with the MHA Keystone Center during the past program year to learn and share best practices to implement the changes necessary to provide safer, more equitable healthcare even amid the COVID-19 pandemic.

Report highlights include:

Members with questions about the report or who would like to request printed copies should contact the MHA Keystone Center.

Age-Friendly Action Community Virtual Format Provides Flexibility in Pandemic

Age-Friendly Action Community

Age-Friendly Health SystemsThe MHA Keystone Center is enrolling Michigan healthcare organizations for its second Age-Friendly Health Systems Action Community, which is designed to prevent harm to older adults and decrease costs from readmissions. The Action Community will run from March to September 2021, and participants will convene to test an evidence-based structure to provide exceptional care for older adults that is known as the 4Ms Framework: What Matters, Medication, Mentation and Mobility.

The MHA Keystone Center Age-Friendly Health Systems Action Community’s virtual curriculum allows members the flexibility to engage at their own pace. Each webinar will be recorded and shared with participants, and members will have access to the MHA Age-Friendly Action Community webpage to post questions and view resources at their convenience. Additionally, the Action Community curriculum will build on participants’ existing practices, resulting in a shift in care rather than adding work to current efforts.

4Ms FrameworkThe COVID-19 pandemic has heightened the awareness and importance of advanced care planning and the need to act on each of the 4Ms. Becoming an Age-Friendly Health System will equip healthcare organizations to have critical conversations with older adults that will help develop treatment plans that best match their wants and needs. This is particularly important for individuals living in healthcare settings that increase the risk of person-to-person COVID-19 transmission among patients and staff and serious illness related to COVID-19 infection.

Further, subject matter experts will help form creative solutions to navigate obstacles caused by the pandemic. The Action Community’s webinar content will adjust to match the needs of its participants, which promotes collaboration and problem-solving among members.

Hospital-based, ambulatory care and extended care teams interested in participating in this Action Community may enroll at no cost. Members with questions may contact the MHA Keystone Center.

Twitter Chat to Discuss Intersection of COVID-19 and Age-Friendly Care

Age Friendly Twitter Chat

Age-Friendly Twitter ChatThe impact of the COVID-19 pandemic on the healthcare industry is far-reaching. One key lesson that has surfaced is the urgent need for age-friendly healthcare. Given that older adults are at a higher risk for morbidity and mortality related to COVID-19, the MHA Keystone Center continues to serve as a resource to support communities and healthcare teams working to provide evidence-based care to this population (see related article).

To help educate and encourage conversation around expanding care practices for older adults, the MHA Keystone Center will host a Twitter Chat from noon to 1 p.m. Feb. 18 to discuss the urgent need for age-friendly healthcare. During the event, the MHA Keystone Center will moderate and lead the conversation, asking questions from @MHAKeystoneCtr. MHA-member hospitals are encouraged to share their current initiatives and success stories using the hashtag #KeystoneAgeFriendly.

The Twitter chat will facilitate discussion around how the COVID-19 pandemic has affected older adults, why improving care for this population should be a priority, steps organizations can take for improving care and more. The questions for the Feb. 18 Twitter Chat can be found on the MHA Keystone Center’s Older Adults webpage. To confirm participation, members should contact the MHA Keystone Center.

Viewing Age-Friendly Care Through an “Equity Lens”

Age-Friendly Action Community

Age-Friendly Health System Action CommunityFactors such as race, ethnicity, language, gender, sexual identity, age, disability, socioeconomic status and geographic location significantly influence health outcomes. These must be considered when providing care to vulnerable populations, such as those ages 65 and older.

Older adults are also at high risk for getting sick and dying from COVID-19, and minority groups are among the highest risk. An analysis of data from the Centers for Disease Control and Prevention found that African Americans ages 65 to 74 died of COVID-19 five times as often as whites. The implications of the pandemic reach beyond contracting the disease — increased rates of social isolation and loneliness remain a concern. 

The MHA Keystone Center Age-Friendly Health Systems Action Community will work with members to view older adult care through an “equity lens,” ensuring that all processes, programs and practices support equitable care for all patients. The Action Community will focus on providing care during the COVID-19 pandemic, recognizing that social determinants of health impact the aging population significantly, especially in their ability to follow up on their care.

Participants will implement an evidence-based framework within their existing practices in addition to learning from subject matter experts and peers to improve care for older adults and reduce costs. Additionally, the Action Community is flexible and will adapt to meet the needs of its participants who are battling the constantly evolving pandemic. 

Healthcare teams interested in participating in this Action Community can enroll online at no cost. In addition, the MHA Keystone Center will host a Twitter chat from noon to 1 p.m. Feb. 18 to discuss the need for age-friendly healthcare (see related article) Members with questions may contact the MHA Keystone Center.

Statewide Data Show Benefits of Age-Friendly Health Systems

Age-Friendly Action Community

Age-Friendly Health Systems Action CommunityMany older adults have more than one chronic disease and take multiple medications, which has many healthcare implications. With advanced age, medical care and treatment become more complex. In 2019, statewide data shows:

  • There were over 100,000 Michigan inpatient admissions per the Michigan Inpatient Database. Of those, approximately 41.9% were patients who were over the age of 65.
  • 16.1% of inpatients over the age of 65 who were considered at-risk discharges were readmitted.
  • 17.1% of all emergency department visits were made by patients 65 and older, according to the Michigan Outpatient Database.

Healthcare organizations need to be equipped to meet the needs of this rapidly growing population. Therefore, the MHA Keystone Center is launching a second cohort of the Age-Friendly Health Systems Action Community to assist hospitals and healthcare organizations in supporting the needs of Michigan’s older adults.

Throughout the seven-month Action Community, participants will build on existing practices within their organizations and enhance them to reliably implement the evidence-based framework referred to as the 4Ms: What Matters, Medication, Mentation and Mobility. This framework is designed to ensure that all older adults receive high-quality care in each setting, resulting in improved health outcomes for these patients and lower costs.

The Age-Friendly Health Systems Action Community will launch in March and is open to hospital-based, ambulatory care and extended care teams. The Action Community will adapt the content to best meet the needs of healthcare organizations during the evolving pandemic. An informational webinar will be held Jan. 21 to discuss the program timeline and overall framework. 

Healthcare teams interested in participating in this Action Community can find additional information and enroll online. Members with questions may contact the MHA Keystone Center.

Boards to Discuss How to Lead Progress on Health Equity and Elder Care

Health inequity and the clinical practices that exponentially improve care for the elderly are areas hospital and health system board members need to proactively address. To help governing boards examine these issues, the MHA is offering a pair of webinars.

The Governing Board’s Role in Health Equity be offered from noon to 1:30 p.m. Jan. 21. The webinar will feature Renée Branch Canady, PhD, a national thought leader in the areas of health inequities and disparities, cultural competence and social justice. Canady will outline the many dimensions of disparities that exist and board members’ role in building accountability for health inequity. In addition, health equity resources available through the MHA Keystone Center will be discussed.

The webinar Age-Friendly Health Systems: A Model for Delivering Reliable Geriatric Care will be held from noon to 1:30 p.m. Feb. 9. This session will outline how age-friendly practices fit into a healthcare organization’s strategic priorities and highlight ways one system is embracing age-friendly practices to reduce length of stay and improve patient satisfaction.

The webinars are offered free of charge, but members must register to receive dial-in instructions. Questions about these webinars should be directed to Erin Steward at the MHA.

MHA Monday Report Dec. 14, 2020

MHA Monday Report logo

Combating the Novel Coronavirus (COVID-19): Week of Dec. 7

Developments with the novel coronavirus are occurring quickly, as the first shipments of the Pfizer COVID-19 vaccine have gone out and the federal government continues to grapple with legislation to assist American businesses and residents. The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage.  …


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The Keckley Report

Not-for-profit Hospitals Get Unwelcome Attention at a Critical Time

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News to Know

A national webinar to review the 2021 Medicare fee-for-service outpatient prospective payment system final rule and hospital-specific impact analysis will be available from 3 to 4 p.m. Jan. 5.

Governance Webinars Focus on Recovery and the Future

Governing board members for healthcare organizations need to learn and share to move from the pandemic response to recovery and rebuilding. The MHA Health Foundation is offering two webinars that provide opportunities to think strategically about two critical issues: health equity and understanding where patients are in their healthcare journey.

To achieve health equity for all, leaders must make health equity a strategic goal, create cross-sectional partnerships inside and outside healthcare to remove obstacles that adversely impact health outcomes, and share in the responsibility for addressing disparities. The webinar The Governing Board’s Role in Health Equity, scheduled from noon to 1:30 p.m. Jan. 21, will outline the many dimensions of disparities that exist and how board members can lead and support accountability for health equity efforts.

A key lesson that has surfaced during the coronavirus pandemic is the urgent need for age-friendly healthcare. Older adults and individuals with underlying, serious medical conditions are at higher risk for morbidity and mortality related to COVID-19. The webinar Age-Friendly Health Systems: A Model for Delivering Reliable Geriatric Care is offered from noon to 1:30 p.m. Feb. 9 and demonstrates how age-friendly practices fit into organizations’ strategic priorities, outlining how these concepts support the care continuum and the community.

The webinars are offered free of charge. Dial-in instructions will be emailed following registration for each session. Questions should be directed to Erin Steward at the MHA.