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00:00:01:02 - 00:00:26:02
Tom Haederle
Welcome to Advancing Health. About a decade ago, Froedtert Menomonee Falls Hospital in Wisconsin decided to focus on improving care and services for its geriatric population of patients. In today's podcast, we learn more from a Froedtert clinical nurse specialist about how its age-friendly journey is advancing the quality of care for older adults.
00:00:26:04 - 00:00:43:01
Jen Braun
Hi everyone! I'm Jen Braun, director of workforce and organizational development at the American Hospital Association, and my guest today is Shelly Hart, who's the clinical nurse specialist at Froedtert Menominee Falls Hospital. Thanks for joining me, Shelly. I was wondering if you could share a little bit about yourself and what you do at Froedtert.
00:00:43:04 - 00:00:59:23
Shelley Hart, R.N.
As you said, I'm a clinical nurse specialist, and I've worked at Froedtert Menomonee Falls Hospital for many decades. I have geriatric background. And so I was very instrumental in when we started to develop our age-friendly status.
00:01:00:00 - 00:01:06:04
Jen Braun
So tell me a little bit more about how your organization began their age-friendly journey.
00:01:06:07 - 00:01:46:23
Shelley Hart, R.N.
I will tell you a little story because it started many, many years ago - right around 2015, 2016 - when we decided we needed to develop an ACE unit. And at that point we thought we needed to do lots of different things to be much more attuned to our geriatric patient population. So, at that point, we started training using our niche protocols and our nursing assistants and RNs learned a lot about geriatric assessments, protocols, discharge planning, etc. and then we also put into place a lot of other protocols for the providers to use.
00:01:46:25 - 00:02:31:21
Shelley Hart, R.N.
We are very fortunate because of our pharmacists and how we have lots of medication guidelines and other daily work that they do supporting age-friendly geriatric patient populations. And we also roped in our geriatricians and they were very supportive and did a lot of work, preparing us. So when we started looking at all of these protocols, everything that we're doing in terms of 4Ms, with mentation, with mobility, with medication and what matters, we had a lot of things already in place that we just had to pull together and look at how we were doing with that.
00:02:31:22 - 00:02:46:06
Shelley Hart, R.N.
How could we do better, and how could we spread this to other areas in the hospital and make this really well received by everybody and make an impact? And so that led us to our age-friendly journey.
00:02:46:08 - 00:03:04:03
Jen Braun
That's amazing. So it sounds like you had a lot of the pieces in place for the 4Ms, which you mentioned were what matters medications, mentation and mobility. And you just had to kind of button them up a little bit. What were some of the interventions, though, that you, that you made to help provide that age-friendly care?
00:03:04:09 - 00:03:30:12
Shelley Hart, R.N.
And that is really, you know, one of the really great pieces about using the 4Ms framework, because you can integrate that into lots of existing things you're already doing. So, for example, what matters in our organization as we really are leveraging our providers when they're talking about goals of care with patients. And they already had a smart phrase that was developed for that.
00:03:30:13 - 00:04:00:29
Shelley Hart, R.N.
So we harnessed that. We also tightened up our medication review, all the daily work our pharmacists are doing. We're really grateful that they use our Beers list criteria and all of the work when they are calling about deprescribing or changing dosing of different medications. I do have to say we did tighten up, you know, our mobility screening, mobility activities, delirium screening and delirium activities.
00:04:00:29 - 00:04:27:05
Shelley Hart, R.N.
And I if I could, I'd like to just explain a little bit more about our mentation and how we have a really robust delirium prevention group within our system and also within our community hospital of Menominee Falls. And, we've just developed some education around that, doing education posts every 1 to 2 weeks so everybody can look at that.
00:04:27:08 - 00:04:53:29
Shelley Hart, R.N.
We also developed a delirium champion program. So now we have unit champions coming. And there's many stories I could share about the delirium champions and all the work they're doing. This is just within the last year or so. We're also just celebrated our delirium awareness day. We took a wellness cart around the hospital. We talked about delirium awareness, delirium prevention, extremely well received.
00:04:54:00 - 00:05:04:24
Shelley Hart, R.N.
So that was with ED, ICU, our stepdown units and all of that surge. So those are all activities we've been doing that just keep spreading age-friendly.
00:05:04:26 - 00:05:25:27
Jen Braun
That's incredible. You've mentioned so many strategies that you've employed. And you know, health care is a team sport. And there are sounds like many, many, many teams involved, many stakeholders. So how did you get engagement and ownership with some of those key stakeholders or what strategies did you employ?
00:05:25:29 - 00:05:59:10
Shelley Hart, R.N.
We are really lucky because our executives actually talked about: You know what? There's this age-friendly action community going on. You guys have a lot of experience with this. You're really subject matter experts, and I'm talking about myself and our director, Sheri Katzer. Would you guys like to lead this work and include our geriatricians and our subject matter expert pharmacists and all of our interdisciplinary therapists?
00:05:59:10 - 00:06:19:21
Shelley Hart, R.N.
And we're like, sure, let's do it. So that was, you know, coming from executives as well as one of our vice presidents. What is their length of stay? How can we make it the best for them meeting their needs? Just employing all those and that's how we actually were propelled into doing the age-friendly submission.
00:06:19:25 - 00:06:34:11
Jen Braun
So it sounds like you had a lot of leadership support from the jump. Did you have any stakeholders who are a bit challenging to get, you know, over the curve there, or what did you specifically do to, do any outreach to them?
00:06:34:14 - 00:07:00:06
Shelley Hart, R.N.
I do think as a group meeting understanding age-friendly, really, and doing a gap analysis. What do we have? What are we working towards? Helping people understand what is what matters mean? What is the medication piece mean? What does mentation piece mean? What does this actually mean in your work? In your daily work? How can we quantify that?
00:07:00:09 - 00:07:09:08
Shelley Hart, R.N.
How can we make it work and improve it? And how can we spread it to the hospital? And at this point, we want to spread it into the system. And what's the next steps for that?
00:07:09:15 - 00:07:12:06
Jen Braun
And so, speaking of, what are the next steps for that?
00:07:12:08 - 00:07:38:13
Shelley Hart, R.N.
And you know, it's great that we're here and there's people really looking forward to us bringing back all the information from today. We really want to talk about dashboards, metrics, quantifying data. We're looking at the CMS, age-friendly measure. How is that impacting things? What can we do to improve? Let's set us up for success. And of course, the patient. That, you know, that's the primary center of everything.
00:07:38:15 - 00:07:49:13
Jen Braun
So how is participating in an AHA age-friendly health systems action community contributed to your work or Froedtert'success?
00:07:49:15 - 00:08:18:25
Shelley Hart, R.N.
Lots and lots of older adults come into the hospital, so we want to make it the best experience for them. We want to make it, what matters to them a lot. A lot of dignity involved in what's going on for the patient, what's going on for their family. And, really, that helps with success of the organization in terms of the patient satisfaction, family satisfaction, all the health care workers working best practice.
00:08:18:27 - 00:08:37:01
Shelley Hart, R.N.
And it's every patient, every time. So it's really an exciting time. And I think everybody should take advantage of age-friendly because there's energy in it. So that's a big piece of it too, is you focus the energy on age-friendly and we're all working towards the same goal.
00:08:37:04 - 00:08:46:24
Jen Braun
You mentioned some of the impacts that you've seen from delivering age-friendly care. Are there any impacts that you want to specifically call out that you're really proud of?
00:08:46:26 - 00:09:12:02
Shelley Hart, R.N.
Well, there's a lot of patient stories I could go into about how training of nurses, training of nursing assistants, providers, and how they centered care around what matters to the patient. From you know, couples that are in the hospital in different places at the same time and how we're getting them together for lunch and people making that happen.
00:09:12:04 - 00:09:33:25
Shelley Hart, R.N.
Families, you know, thinking, you know, mom hasn't been doing so well over the course of the months. Can I talk about this? We need to really talk about this and someone listening and say, yeah, let's get together. We're going to have a family meeting about this, and they get the right players involved to make it best for the patient.
00:09:33:27 - 00:09:42:14
Shelley Hart, R.N.
Those are just a couple, like, stories that happen all the time, and that is not possible unless you're all in sync.
00:09:42:17 - 00:09:57:03
Jen Braun
So, Shelly, I just want to thank you for sharing all the work that Froedtert has done, and you have done to implement the 4Ms at your system to ensure that older adults are receiving quality care. So I really want to thank you for sharing your story and your time here today.
00:09:57:06 - 00:10:03:04
Shelley Hart, R.N.
You're very welcome. I am really happy to be here and to share stories.
00:10:03:07 - 00:10:11:18
Tom Haederle
Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts.
