Embedding Two of the 4Ms Into the Electronic Health Record: One Health System’s Journey Towards Systemwide Spread of Age-Friendly Care

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Publicado en:Inquiry vol. 62 (Jan 2025)
Autor principal: Anna-Rae Montano
Otros Autores: Waszynski, Christine
Publicado:
SAGE PUBLICATIONS, INC.
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Acceso en línea:Citation/Abstract
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100 1 |a Anna-Rae Montano  |u Hartford Hospital, CT, USA 
245 1 |a Embedding Two of the 4Ms Into the Electronic Health Record: One Health System’s Journey Towards Systemwide Spread of Age-Friendly Care 
260 |b SAGE PUBLICATIONS, INC.  |c Jan 2025 
513 |a Journal Article 
520 3 |a The purpose of this article is to describe 2 quality improvement projects aimed at embedding 2 of the 4Ms into the electronic health record for system-wide spread of Age-Friendly care. The 2 projects described in this case study serve as exemplars for the future implementation and sustainability of 4Ms care. Rapid-cycle quality improvement projects, via the Plan, Do, Study Act model, focused on the 4Ms were conducted by interprofessional teams to integrate clinical decision support for clinicians within the electronic health record. Project Senior Care Review for Evaluating and Eliminating Non-essential and potentially inappropriate medications (SCREEN) embedded a geriatric medication screen into the ordering panels of the top medications identified as being prescribed to older patients potentially inappropriately. Project Predictive Real-time Evaluation of Delirium in Clinical Therapy (PREDICT) embedded a delirium prediction rule in the electronic health records to guide clinicians to implement delirium mitigation interventions on patients at risk of developing or experiencing delirium. Outcomes were evaluated descriptively utilizing data and reports generated by the electronic health record. Embedding non-interruptive and actionable clinical decision support in the electronic health record supported the rapid spread of Age-Friendly care across a 7-hospital system. The 4Ms can be embedded into existing workflows through novel implementation of best practices by leveraging the electronic health record. By embedding 2 of the 4Ms into existing workflows and creating non-disruptive, actionable clinical decision support within the electronic health record, clinicians have the tools to implement Age-Friendly care within the 4Ms framework. Additional projects aimed at embedding the other Ms are underway, and long-term outcomes are being evaluated. 
653 |a Quality management 
653 |a Morphine 
653 |a Age 
653 |a Quality of care 
653 |a Medical records 
653 |a Intervention 
653 |a Drug stores 
653 |a Delirium 
653 |a Older people 
653 |a Health 
653 |a Computerized physician order entry 
653 |a Health care 
653 |a Medical personnel 
653 |a Case studies 
653 |a Quality improvement 
653 |a Drugs 
653 |a Patients 
653 |a Health services 
653 |a Risk factors 
653 |a Age differences 
653 |a Best practice 
653 |a Rules 
653 |a Mitigation 
653 |a Electronic health records 
653 |a Clinical outcomes 
653 |a Medical decision making 
653 |a Inappropriateness 
653 |a Clinical decision making 
653 |a Decisions 
653 |a Medical treatment 
653 |a Computerized medical records 
653 |a Interdisciplinary aspects 
653 |a Geriatrics 
653 |a Health records 
653 |a Systematic review 
653 |a Critical care 
653 |a Computerized decision support systems 
700 1 |a Waszynski, Christine  |u Hartford Hospital, CT, USA 
773 0 |t Inquiry  |g vol. 62 (Jan 2025) 
786 0 |d ProQuest  |t ABI/INFORM Global 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3287008667/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3287008667/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3287008667/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch