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Implementation of the Age-Friendly Health Systems Initiative in the Department of Veterans Affairs: 5 Years of Improving Quality for Older Veterans.

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Title: Implementation of the Age-Friendly Health Systems Initiative in the Department of Veterans Affairs: 5 Years of Improving Quality for Older Veterans.
Authors: Schwartz, Andrea Wershof1,2,3 (AUTHOR) andrea.schwartz@va.gov, Jindal, Shivani K.4,5,6 (AUTHOR), Wozneak, Kimberly A.4 (AUTHOR), Burke, Robert E.7,8,9 (AUTHOR)
Source: Inquiry (00469580). 9/1/2025, Vol. 62, p1-10. 10p.
Subject Terms: *Age, *Theory, *Committees, Evaluation of human services programs, Dashboards (Management information systems), Medical quality control, Research funding, Patients, Medical care, Hospital admission & discharge, Evaluation of medical care, Nursing care facilities, Mathematical models, Conceptual structures, Quality assurance, Hospital health promotion programs, Veterans' hospitals
Geographic Terms: United States
Company/Entity: United States. Dept. of Veterans Affairs
Abstract: Introduction: The Age-Friendly Health Systems initiative (AFHS) was developed to spread principles of high-quality care for older adults using the 4Ms Framework: What Matters, Medications, Mentation and Mobility. In 2020, the Veterans Health Affairs (VA) set a goal to become an AFHS, given nearly half of Veterans are over aged 65. Methods: This quality improvement study followed the Model for Improvement which guided a series of Plan Do Study Act (PDSA) cycles to implement and spread the AFHS model within the VA, as measured by clinical sites receiving AFHS recognition from the Institute for Healthcare Improvement (IHI). A national AFHS Steering Committee was formed, followed by a 4Ms note template and dashboard. VA ran 3 AFHS Action Communities which included synchronous training sessions and coaching calls in 4Ms care. IHI recognition was tracked over 5 years for VA sites. The Standards for Quality Improvement Reporting Excellence 2.0 guidelines (SQuIRE) were used. Results: From 2020 to 2025, 455 VA care settings earned Level 1 recognition from IHI at 138/139 (99%) of VA parent facilities. 268/455 (59%) sites have gone on to achieve Level 2 recognition. 66% of Level 1 sites are ambulatory, 7% are acute care, and 24% are nursing homes. Since 2022 when the VA AFHS note template was implemented, 163 000 unique Veterans have been recorded as having been reached with 4Ms care, of whom 71% reside in urban areas, 23% are aged 85 and older, and 59% are aged 65 to 84. Conclusion: The VA implemented the AFHS initiative at nearly all VA parent facilities over 5 years, spreading the 4Ms model of Age-Friendly care across geographic and care settings. Further study is needed on the clinical impact of and optimal implementation strategies for AFHS. The VA experience offers a promising model for health systems seeking to implement AFHS. [ABSTRACT FROM AUTHOR]
Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Implementation of the Age-Friendly Health Systems Initiative in the Department of Veterans Affairs: 5 Years of Improving Quality for Older Veterans.
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  Data: <searchLink fieldCode="JN" term="%22Inquiry+%2800469580%29%22">Inquiry (00469580)</searchLink>. 9/1/2025, Vol. 62, p1-10. 10p.
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  Data: <searchLink fieldCode="DE" term="%22United+States%2E+Dept%2E+of+Veterans+Affairs%22">United States. Dept. of Veterans Affairs</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Introduction: The Age-Friendly Health Systems initiative (AFHS) was developed to spread principles of high-quality care for older adults using the 4Ms Framework: What Matters, Medications, Mentation and Mobility. In 2020, the Veterans Health Affairs (VA) set a goal to become an AFHS, given nearly half of Veterans are over aged 65. Methods: This quality improvement study followed the Model for Improvement which guided a series of Plan Do Study Act (PDSA) cycles to implement and spread the AFHS model within the VA, as measured by clinical sites receiving AFHS recognition from the Institute for Healthcare Improvement (IHI). A national AFHS Steering Committee was formed, followed by a 4Ms note template and dashboard. VA ran 3 AFHS Action Communities which included synchronous training sessions and coaching calls in 4Ms care. IHI recognition was tracked over 5 years for VA sites. The Standards for Quality Improvement Reporting Excellence 2.0 guidelines (SQuIRE) were used. Results: From 2020 to 2025, 455 VA care settings earned Level 1 recognition from IHI at 138/139 (99%) of VA parent facilities. 268/455 (59%) sites have gone on to achieve Level 2 recognition. 66% of Level 1 sites are ambulatory, 7% are acute care, and 24% are nursing homes. Since 2022 when the VA AFHS note template was implemented, 163 000 unique Veterans have been recorded as having been reached with 4Ms care, of whom 71% reside in urban areas, 23% are aged 85 and older, and 59% are aged 65 to 84. Conclusion: The VA implemented the AFHS initiative at nearly all VA parent facilities over 5 years, spreading the 4Ms model of Age-Friendly care across geographic and care settings. Further study is needed on the clinical impact of and optimal implementation strategies for AFHS. The VA experience offers a promising model for health systems seeking to implement AFHS. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1177/00469580251366883
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      – Code: eng
        Text: English
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        PageCount: 10
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    Subjects:
      – SubjectFull: Age
        Type: general
      – SubjectFull: Theory
        Type: general
      – SubjectFull: Committees
        Type: general
      – SubjectFull: Evaluation of human services programs
        Type: general
      – SubjectFull: Dashboards (Management information systems)
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      – SubjectFull: Patients
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      – SubjectFull: Medical care
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      – SubjectFull: Hospital admission & discharge
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      – SubjectFull: Evaluation of medical care
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      – SubjectFull: Nursing care facilities
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      – SubjectFull: Hospital health promotion programs
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      – SubjectFull: Veterans' hospitals
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      – SubjectFull: United States
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      – SubjectFull: United States. Dept. of Veterans Affairs
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      – TitleFull: Implementation of the Age-Friendly Health Systems Initiative in the Department of Veterans Affairs: 5 Years of Improving Quality for Older Veterans.
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              Text: 9/1/2025
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