Collaborating toward equity in Pennsylvania: The Age‐Friendly Care, PA project
Objective To collaboratively implement the age‐friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center. Data Sources Data were collected from PHN electronic medical records (EMRs)...
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| Veröffentlicht in: | Health services research 2023-02, Vol.58 (1), p.78-88 |
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| creator | Berish, Diane Husser, Erica Knecht‐Fredo, Jenny Sabol, Jacqueline Garrow, George Hupcey, Judith Fick, Donna |
| description | Objective
To collaboratively implement the age‐friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center.
Data Sources
Data were collected from PHN electronic medical records (EMRs) for individuals over age 65 from December 30, 2019 to December 24, 2021 and from Project ECHO© attendance and evaluation surveys.
Study Design
The telementoring educational program, Project ECHO©, was used to engage PHN health care professionals working in rural areas of Pennsylvania to incorporate the 4Ms into their practice starting with the annual wellness visit (AWV). Project ECHO© was launched at three primary care sites. After 18 months, it was then disseminated to an additional 18 sites creating pilot and comparison groups. Outcomes included codesigned patient process metrics using EMR data and project ECHO© participant data.
Data Collection Methods
EMR data were generated by system reports created by PHN's quality assurance program manager. Project ECHO© data were collected and managed using REDCap electronic data capture tools. Outcomes were aggregated, analyzed for trends over time, and compared between groups.
Principal Findings
All nine process outcomes increased from baseline to follow‐up at the three initial sites, ranging from 4% to 43% g. At year two, the three initial sites had higher rates on AWVs (pilot 24%, comparison 12%; p |
| doi_str_mv | 10.1111/1475-6773.14073 |
| format | Article |
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To collaboratively implement the age‐friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center.
Data Sources
Data were collected from PHN electronic medical records (EMRs) for individuals over age 65 from December 30, 2019 to December 24, 2021 and from Project ECHO© attendance and evaluation surveys.
Study Design
The telementoring educational program, Project ECHO©, was used to engage PHN health care professionals working in rural areas of Pennsylvania to incorporate the 4Ms into their practice starting with the annual wellness visit (AWV). Project ECHO© was launched at three primary care sites. After 18 months, it was then disseminated to an additional 18 sites creating pilot and comparison groups. Outcomes included codesigned patient process metrics using EMR data and project ECHO© participant data.
Data Collection Methods
EMR data were generated by system reports created by PHN's quality assurance program manager. Project ECHO© data were collected and managed using REDCap electronic data capture tools. Outcomes were aggregated, analyzed for trends over time, and compared between groups.
Principal Findings
All nine process outcomes increased from baseline to follow‐up at the three initial sites, ranging from 4% to 43% g. At year two, the three initial sites had higher rates on AWVs (pilot 24%, comparison 12%; p < 0.0001), Advance Care Planning (New on file, pilot 8%, comparison 2%; Discussed with patient, pilot 18%, comparison 13%; Patient declined, pilot 0%, comparison 0%; p = 0.0001), Dementia Screening (pilot 24%, comparison 12%; p < 0.0001), Fall Risk Management (pilot 43%, comparison 10%; p < 0.0001), and Mobility Goal (pilot 19%, comparison 9%; p < 0.0001); and lower rates on High‐Risk Medication Elimination (pilot 54%, comparison, 63%, p < 0.02).
Conclusions
Access to high‐quality geriatric care for rural older adults can be improved by increasing health care professionals' knowledge of the 4Ms, beginning with its incorporation into the AWV.</description><identifier>ISSN: 0017-9124</identifier><identifier>EISSN: 1475-6773</identifier><identifier>DOI: 10.1111/1475-6773.14073</identifier><identifier>PMID: 36129432</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Age ; Aged ; Care plans ; Clinical outcomes ; Computerized medical records ; Data capture ; Data collection ; Delivery of Health Care ; Dementia ; Dementia disorders ; Drugs ; Educational programs ; Elderly ; Electronic health records ; Electronic medical records ; Elimination ; Evaluation ; Forecasts and trends ; Health aspects ; Health care ; Health care facilities ; Health care reform ; health care systems ; Health education ; health equity ; Health facilities ; Health Personnel ; health services for older adults ; Humans ; Market trend/market analysis ; Medical personnel ; Medical records ; Medical screening ; Mobility ; Older people ; Patient communication ; Patients ; Pennsylvania ; Primary care ; Quality assurance ; Quality control ; Quality of Health Care ; Risk management ; Rural areas ; Rural communities ; rural population ; Surveys and Questionnaires</subject><ispartof>Health services research, 2023-02, Vol.58 (1), p.78-88</ispartof><rights>2022 Health Research and Educational Trust.</rights><rights>COPYRIGHT 2023 Health Research and Educational Trust</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c7133-df2eba2f3408003ec572943eefcf999886baf94175dfbe84c40d5d61da3ee98a3</citedby><cites>FETCH-LOGICAL-c7133-df2eba2f3408003ec572943eefcf999886baf94175dfbe84c40d5d61da3ee98a3</cites><orcidid>0000-0001-9224-5950</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843075/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843075/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,27901,27902,30976,45550,45551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36129432$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berish, Diane</creatorcontrib><creatorcontrib>Husser, Erica</creatorcontrib><creatorcontrib>Knecht‐Fredo, Jenny</creatorcontrib><creatorcontrib>Sabol, Jacqueline</creatorcontrib><creatorcontrib>Garrow, George</creatorcontrib><creatorcontrib>Hupcey, Judith</creatorcontrib><creatorcontrib>Fick, Donna</creatorcontrib><title>Collaborating toward equity in Pennsylvania: The Age‐Friendly Care, PA project</title><title>Health services research</title><addtitle>Health Serv Res</addtitle><description>Objective
To collaboratively implement the age‐friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center.
Data Sources
Data were collected from PHN electronic medical records (EMRs) for individuals over age 65 from December 30, 2019 to December 24, 2021 and from Project ECHO© attendance and evaluation surveys.
Study Design
The telementoring educational program, Project ECHO©, was used to engage PHN health care professionals working in rural areas of Pennsylvania to incorporate the 4Ms into their practice starting with the annual wellness visit (AWV). Project ECHO© was launched at three primary care sites. After 18 months, it was then disseminated to an additional 18 sites creating pilot and comparison groups. Outcomes included codesigned patient process metrics using EMR data and project ECHO© participant data.
Data Collection Methods
EMR data were generated by system reports created by PHN's quality assurance program manager. Project ECHO© data were collected and managed using REDCap electronic data capture tools. Outcomes were aggregated, analyzed for trends over time, and compared between groups.
Principal Findings
All nine process outcomes increased from baseline to follow‐up at the three initial sites, ranging from 4% to 43% g. At year two, the three initial sites had higher rates on AWVs (pilot 24%, comparison 12%; p < 0.0001), Advance Care Planning (New on file, pilot 8%, comparison 2%; Discussed with patient, pilot 18%, comparison 13%; Patient declined, pilot 0%, comparison 0%; p = 0.0001), Dementia Screening (pilot 24%, comparison 12%; p < 0.0001), Fall Risk Management (pilot 43%, comparison 10%; p < 0.0001), and Mobility Goal (pilot 19%, comparison 9%; p < 0.0001); and lower rates on High‐Risk Medication Elimination (pilot 54%, comparison, 63%, p < 0.02).
Conclusions
Access to high‐quality geriatric care for rural older adults can be improved by increasing health care professionals' knowledge of the 4Ms, beginning with its incorporation into the AWV.</description><subject>Age</subject><subject>Aged</subject><subject>Care plans</subject><subject>Clinical outcomes</subject><subject>Computerized medical records</subject><subject>Data capture</subject><subject>Data collection</subject><subject>Delivery of Health Care</subject><subject>Dementia</subject><subject>Dementia disorders</subject><subject>Drugs</subject><subject>Educational programs</subject><subject>Elderly</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Elimination</subject><subject>Evaluation</subject><subject>Forecasts and trends</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>Health care reform</subject><subject>health care systems</subject><subject>Health education</subject><subject>health equity</subject><subject>Health facilities</subject><subject>Health Personnel</subject><subject>health services for older adults</subject><subject>Humans</subject><subject>Market trend/market analysis</subject><subject>Medical personnel</subject><subject>Medical records</subject><subject>Medical screening</subject><subject>Mobility</subject><subject>Older people</subject><subject>Patient communication</subject><subject>Patients</subject><subject>Pennsylvania</subject><subject>Primary care</subject><subject>Quality assurance</subject><subject>Quality control</subject><subject>Quality of Health Care</subject><subject>Risk management</subject><subject>Rural areas</subject><subject>Rural communities</subject><subject>rural population</subject><subject>Surveys and Questionnaires</subject><issn>0017-9124</issn><issn>1475-6773</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>N95</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkt9u0zAUxi0EYl3hmjsUCQmBtHR2nDgJF0hVtT9IlVbBuLYc5yR1ldqdnWzrHY_AM_IkuLSUBlXgSLZ08jtfvvh8CL0ieET8OidxmoQsTemIxDilT9BgX3mKBhiTNMxJFJ-gU-cWGOOMZvFzdEIZifKYRgM0m5imEYWxolW6DlrzIGwZwF2n2nWgdDADrd26uRdaiQ_B7RyCcQ0_vn2_tAp02ayDibBwFszGwcqaBcj2BXpWicbBy905RF8vL24n1-H05urTZDwNZUooDcsqgkJEFY1xhjEFmaQbRwCVrPI8zzJWiCqPSZqUVQFZLGNcJiUjpfBMngk6RB-3uquuWEIpQbdWNHxl1VLYNTdC8f4brea8Nvc8z2KK08QLvNsJWHPXgWv5UjkJ_jY0mM7xKCUsiRjzdofozV_ownRW-9_zFEtyL8fYH6oWDXClK-O_KzeifJzSjOSZl_NUeISqQYM3aTRUypd7_OgI758SlkoebXjfa_BMC49tLTrneHY1_ZeZHSt9JqAG7gc2uenzbw_4OYimnTvTdK0y2vXBswOw6JzS4PzmVD1v3dZLDz_f4tIa5yxU-zkSzDdB55tY802s-a-g-47Xh-Pf87-T7QG2BR78_az_p8evL7583ir_BJJwBD0</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Berish, Diane</creator><creator>Husser, Erica</creator><creator>Knecht‐Fredo, Jenny</creator><creator>Sabol, Jacqueline</creator><creator>Garrow, George</creator><creator>Hupcey, Judith</creator><creator>Fick, Donna</creator><general>Blackwell Publishing Ltd</general><general>Health Research and Educational Trust</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>N95</scope><scope>XI7</scope><scope>8GL</scope><scope>7QJ</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9224-5950</orcidid></search><sort><creationdate>202302</creationdate><title>Collaborating toward equity in Pennsylvania: The Age‐Friendly Care, PA project</title><author>Berish, Diane ; Husser, Erica ; Knecht‐Fredo, Jenny ; Sabol, Jacqueline ; Garrow, George ; Hupcey, Judith ; Fick, Donna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c7133-df2eba2f3408003ec572943eefcf999886baf94175dfbe84c40d5d61da3ee98a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Aged</topic><topic>Care plans</topic><topic>Clinical outcomes</topic><topic>Computerized medical records</topic><topic>Data capture</topic><topic>Data collection</topic><topic>Delivery of Health Care</topic><topic>Dementia</topic><topic>Dementia disorders</topic><topic>Drugs</topic><topic>Educational programs</topic><topic>Elderly</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Elimination</topic><topic>Evaluation</topic><topic>Forecasts and trends</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health care facilities</topic><topic>Health care reform</topic><topic>health care systems</topic><topic>Health education</topic><topic>health equity</topic><topic>Health facilities</topic><topic>Health Personnel</topic><topic>health services for older adults</topic><topic>Humans</topic><topic>Market trend/market analysis</topic><topic>Medical personnel</topic><topic>Medical records</topic><topic>Medical screening</topic><topic>Mobility</topic><topic>Older people</topic><topic>Patient communication</topic><topic>Patients</topic><topic>Pennsylvania</topic><topic>Primary care</topic><topic>Quality assurance</topic><topic>Quality control</topic><topic>Quality of Health Care</topic><topic>Risk management</topic><topic>Rural areas</topic><topic>Rural communities</topic><topic>rural population</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berish, Diane</creatorcontrib><creatorcontrib>Husser, Erica</creatorcontrib><creatorcontrib>Knecht‐Fredo, Jenny</creatorcontrib><creatorcontrib>Sabol, Jacqueline</creatorcontrib><creatorcontrib>Garrow, George</creatorcontrib><creatorcontrib>Hupcey, Judith</creatorcontrib><creatorcontrib>Fick, Donna</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Business: Insights</collection><collection>Business Insights: Essentials</collection><collection>Gale In Context: High School</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health services research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berish, Diane</au><au>Husser, Erica</au><au>Knecht‐Fredo, Jenny</au><au>Sabol, Jacqueline</au><au>Garrow, George</au><au>Hupcey, Judith</au><au>Fick, Donna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Collaborating toward equity in Pennsylvania: The Age‐Friendly Care, PA project</atitle><jtitle>Health services research</jtitle><addtitle>Health Serv Res</addtitle><date>2023-02</date><risdate>2023</risdate><volume>58</volume><issue>1</issue><spage>78</spage><epage>88</epage><pages>78-88</pages><issn>0017-9124</issn><eissn>1475-6773</eissn><abstract>Objective
To collaboratively implement the age‐friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center.
Data Sources
Data were collected from PHN electronic medical records (EMRs) for individuals over age 65 from December 30, 2019 to December 24, 2021 and from Project ECHO© attendance and evaluation surveys.
Study Design
The telementoring educational program, Project ECHO©, was used to engage PHN health care professionals working in rural areas of Pennsylvania to incorporate the 4Ms into their practice starting with the annual wellness visit (AWV). Project ECHO© was launched at three primary care sites. After 18 months, it was then disseminated to an additional 18 sites creating pilot and comparison groups. Outcomes included codesigned patient process metrics using EMR data and project ECHO© participant data.
Data Collection Methods
EMR data were generated by system reports created by PHN's quality assurance program manager. Project ECHO© data were collected and managed using REDCap electronic data capture tools. Outcomes were aggregated, analyzed for trends over time, and compared between groups.
Principal Findings
All nine process outcomes increased from baseline to follow‐up at the three initial sites, ranging from 4% to 43% g. At year two, the three initial sites had higher rates on AWVs (pilot 24%, comparison 12%; p < 0.0001), Advance Care Planning (New on file, pilot 8%, comparison 2%; Discussed with patient, pilot 18%, comparison 13%; Patient declined, pilot 0%, comparison 0%; p = 0.0001), Dementia Screening (pilot 24%, comparison 12%; p < 0.0001), Fall Risk Management (pilot 43%, comparison 10%; p < 0.0001), and Mobility Goal (pilot 19%, comparison 9%; p < 0.0001); and lower rates on High‐Risk Medication Elimination (pilot 54%, comparison, 63%, p < 0.02).
Conclusions
Access to high‐quality geriatric care for rural older adults can be improved by increasing health care professionals' knowledge of the 4Ms, beginning with its incorporation into the AWV.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>36129432</pmid><doi>10.1111/1475-6773.14073</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9224-5950</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Health services research, 2023-02, Vol.58 (1), p.78-88 |
| issn | 0017-9124 1475-6773 |
| language | eng |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Age Aged Care plans Clinical outcomes Computerized medical records Data capture Data collection Delivery of Health Care Dementia Dementia disorders Drugs Educational programs Elderly Electronic health records Electronic medical records Elimination Evaluation Forecasts and trends Health aspects Health care Health care facilities Health care reform health care systems Health education health equity Health facilities Health Personnel health services for older adults Humans Market trend/market analysis Medical personnel Medical records Medical screening Mobility Older people Patient communication Patients Pennsylvania Primary care Quality assurance Quality control Quality of Health Care Risk management Rural areas Rural communities rural population Surveys and Questionnaires |
| title | Collaborating toward equity in Pennsylvania: The Age‐Friendly Care, PA project |
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