When she asked an elderly patient, who had high blood pressure and diabetes, what was most important to her, Jessica Lee, MD, MS, was surprised by the answer.
We thought it would be about the hypertension. But, it was about her inability to get around by herself. We were able to make some accommodations so that she was able to better maneuver at home. That was a really, really big deal to her because she didn't like asking people for help."
Jessica Lee, assistant professor of geriatric and palliative medicine at McGovern Medical School at UTHealth
Asking patients about their most pressing needs is part of the enhanced care that elderly patients receive from Lee and others on the UTHealth Harris Health House Call Service, one of a number of health care providers that has received special designation as age-friendly, thanks to the efforts of the UTHealth Consortium on Aging.
With the help of the consortium, clinical practices and hospitals including the UT Physicians Center for Healthy Aging, UTHealth Harris County Psychiatric Center (HCPC), Memorial Hermann-Texas Medical Center, and Harris Health Lyndon B. Johnson Hospital earned age-friendly recognition.
This program is part of a nationwide movement to improve health care for older adults called the Age-Friendly Health Systems initiative. The program, operated by the Institute for Healthcare Improvement, has recognized 122 hospitals and health care practices.
"We are the first in the state to earn the committed-to-care excellence designation," said Carmel Dyer, MD, the executive director of the Consortium on Aging and a professor of geriatric and palliative medicine at McGovern Medical School at UTHealth.
The timing for the age-friendly health care initiative could not be better. America's 65-and-over population is projected to nearly double over the next three decades, from 48 million to 88 million by 2050, reports the National Institutes of Health. Seniors typically require more medical services than their younger counterparts.
The idea is to make the care for older adults even more tailored to patient goals and preferences. In addition to asking senior patients what matters most to them, Lee said the age-friendly initiative calls on health care providers to assess older patients about their medications, mental state, and mobility, referred to as the 4Ms.
Maureen Beck, DNP, a gerontological nurse practitioner with McGovern Medical School, said asking patients "What Matters?" is also making a big difference at the UT Physicians Center for Healthy Aging.
"We were doing everything in our clinic but formally asking our patients what mattered. Before we started the Institute for Healthcare Improvement Age-Friendly initiative, we surveyed our employees to find out what mattered to them and received feedback about patient care and what questions we would ask our patients," Beck said.
"We had a choice about how to ask what mattered. I think that asking our staff was a good start because it got them more involved. Our patients appreciate getting asked the question, and they stop to consider their answer. Frequently it involves staying healthy and being independent," Beck said.
Lokesh Shahani, MD, MPH, director of the geriatric psychiatry program at UTHealth HCPC, said, "As the world's population grows, and people on average are living longer, the number of older people will continue to increase. This results in more pressure on health care facilities not only to take on more patients, but also to be ready to offer specialized treatments to an older population."
He said these evidence-based elements of high-quality care "help physicians understand the patient's needs, review plans for each patient, make adjustments if needed, open a discussion involving medications use, and improve any other conditions such as dementia, delirium, and depression."
The Age-Friendly Health Systems initiative was launched in 2017 by The John A. Hartford Foundation and the Institute for Health Improvement with a commitment to make 20% of hospitals and health systems in the United States age-friendly by 2020.
"Delivering improved care to older adults in each setting can help us achieve fewer avoidable hospital readmissions, better outcomes, more contented patients and families, and lower total costs," Dyer said.
As part of the Age-Friendly Health Systems Action Community, UTHealth is testing and implementing a set of evidence-based interventions proven as the essential initial elements needed to provide older patients better care.
The Consortium on Aging is a university-wide collaborative effort that leverages the existing strengths and expertise of all the UTHealth schools, including the Schools of Medicine, Nursing, Dentistry, Public Health, Biomedical Informatics, and Biomedical Sciences.
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