OH Selected for Senior Care Collaborative

By Scott Hagerman, Messenger-Inquirer

Owensboro Health is one of 30 health systems across the United States that has been chosen to participate in a national initiative focused on transforming care for seniors.

Spearheaded by the Institute for Healthcare Improvement (IHI), the Age-Friendly System-Wide Spread Collaborative aims to broadly implement and expedite the adoption of evidence-based care practices for seniors.

“It feels innovative and pioneerish to be involved in this, and that makes it really exciting,” said Ronda Rodgers, Owensboro Health Regional Hospital’s director of nursing professional development.

The initiative is part of the Age-Friendly Health Systems movement, which advocates the 4M framework for care — focusing on what matters, medication, mentation and mobility.

“IHI started in 2017 looking at what is the best way to take care of our older adults, and ended up having an expert panel that came up with the four Ms; that if we focus on these four things we’re going to see our older adults do better as they’re recovering and we’re going to prevent decline and help keep them as healthy as possible,” Rodgers said. 

“We can’t treat them like we can somebody that’s 40. We’ve got to make sure we’re doing what we need to do to keep them safe and keep them able to perform their normal activities of daily living.” 

Owensboro Health Regional Hospital was recognized by IHI in 2019 when it received the Committed to Care Excellence designation for its work with seniors. The hospital’s transitional care unit, which is a separate licensed facility, earned the designation shortly after the hospital, and in 2023 the Family Medicine — Breckinridge facility was recognized. Rodgers said OH’s past success made it a natural for the collaborative.

“I think because we had progressively had different entities within our system that were beingrecognized, we were invited in January of 2024 to apply for participation in (the collaborative), they invited lots of systems all over the hospital, the goal being, you’ve already got some of your entities involved in this, are you willing to spread it to your whole health system,” she said. “We were like, ‘What an opportunity; this is great for them to have to be able to do this in a formalized structure with IHI.’ ”

Owensboro Health learned it was accepted in March. It’s the only facility in Kentucky that’s part of the collaborative, with the nearest collaborator outside Chicago.

As part of its commitment to the initiative, OH pledges to expand the use of its 4M framework to Owensboro Health Twin Lakes Medical Center in Leitchfield and Owensboro Health Muhlenberg Community Hospital in Greenville. It will also incorporate the procedures at two long-term care units, five urgent care facilities and 15 primary care facilities.

“For the collaborative, our goal is to make sure that we’re implementing all four of the four Ms on all of our patients that are 65 and older,” Rodgers said. “There’s percentage goals. We’ve built a launch plan, and right now we’re working with IT very heavily to develop ways that we can document and assess these four big categories and that we’re acting on them. It’s not just that we’re seeing how we’re doing, but that we’re also implementing change to make sure we’re doing the best we can for these older patients.”

Two representatives from OH attended an in-person meeting with representatives from the other collaborative members to discuss implementation. OH has developed training teams, with one team working with the in-patient unit and long-term care facilities at all three hospitals. The other team is working with all ambulatory sites, primary care offices and urgent care centers. Both teams are working to put into place what will be needed to be able to meet the collaborative goals.

“The goal is we’ll educate at each of the hospitals and each of the ambulatory sites, and we’ll roll out implementation a couple at a time; we’ll educate,” Rodgers said. “We’ll take a month to trial the process, and then we’ll measure for three months in a row to learn what percentage of our older adult patients, over 65, are getting all four of those four Ms in their care. That’s where the pioneers in this are seeing improvement.

“What they saw is when you implement the four Ms consistently with those patients, you start to decrease length of stay, and improvement in mobility means they may be able to do what matters longer, be mobile and not be on medications that keep you from being able to do things you want to do.”

Rodgers said having the ability to interact with other collaborators will be very beneficial. “There are going to be three different times when we all are on Zoom calls together, and we’re paired up with a triad of hospitals that have similar goals to ours,” Rodgers said. “We have already had our first online meeting with them. Those are so valuable. You’re able to talk about what you’re doing and where you’re running up against a barrier. We can ask, ‘Have you experienced that, what did you do?’ One of the neat things about doing it in this collaborative is we’ve got this guidance, these coaching calls, to make sure we stay on track and that the work is developing and giving us a lot of great ideas.”

In addition to improving care for seniors, the collaborative also puts OH in a good position when it comes to meeting the criteria set by the Centers for Medicare and Medicaid Services for receiving payment. “CMS is working toward age-friendly care becoming mandatory for all hospitals,” Rodgers said. “There’s going to come a time when it could even affect Medicare payments, that type of thing. We’ll be ahead of the game; we’ll be already doing what we need to do, and we’ll have the opportunity to do it with all of this support instead of just hearing, ‘OK, you’ve got to put this in place within the next year and have to do it on our own.’ ”