Age-Friendly Health Systems

Addressing the unique care needs of older adults.

Age-friendly health care is an urgent need. There are more than 46 million Americans age 65 and over, and that number is projected to double to more than 98 million by 2060.

Many older adults have more than one chronic disease and take multiple medications. Many individuals in this population of people live with uncertainty as they transition from living independently to reliance on others.

Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) in partnership with the American Hospital Association and the Catholic Health Association of the United States (CHA). The initial goal was to rapidly spread the 4Ms Framework to 20% of U.S. hospitals and medical practices by 2020.

This initiative exceeded its original goal, and more than 1,950 health care organizations joined the movement by the end of 2020. The work will continue for the Age-Friendly Health Systems partners, who are aiming to recognize 2,600 organizations by June 2023.

This work is part of the AHA’s commitment to improving the health of people at every life stage and in communities across the country.

The “4Ms” Framework

  • What Matters: Know and align care with each older adult’s specific health outcome goals and care preferences including, but not limited to, end-of-life care, and across settings of care.
  • Medications: If medications are necessary, use age-friendly medications that do not interfere with What Matters, Mentation or Mobility.
  • Mentation: Prevent, identify, treat and manage depression, dementia and delirium across settings of care.
  • Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters.

An Age-Friendly Health System is one in which every older adult’s care:

  • Is guided by an essential set of evidence-based practices (the 4Ms);
  • Causes no harms; and
  • Is consistent with What Matters to the older adult and their family.

Additional information and resources about the Age Friendly Health Systems Initiative and 4Ms Framework can be found at Institute for Healthcare Improvement.

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the AHA Action Community

The AHA is currently recruiting for its third Age-Friendly Health Systems Action Community convening September 2021, with acute, post-acute and outpatient sites of care. Age-Friendly Health Systems action communities, led by AHA and IHI, test the 4Ms Framework in hospital and ambulatory settings, sharing learnings in a seven-month virtual community.

The first AHA Action Community concluded in April 2020, with 184 health care teams and 12 allied associations across the U.S. participating. The second AHA Action Community concluded in April 2021, with 135 health care teams across the U.S. and world participating.

The benefits of the Action Community include:

  • Redeploying and prioritizing existing hospital/health system resources.
  • Supporting your health organization’s mission, vision and values.
  • Putting your organization ahead of the curve in preparing for the impending market shift.
  • Achieving “Age-Friendly Health Systems Participant” or "Committed to Care Excellence" recognition. 

To find out more about the Age-Friendly Health Systems Action Community, download our flyer. View more information about how you can participate by visiting IHI's Age-Friendly webpage. Email ahaactioncommunity@aha.org for additional information or to ask questions.

 
 
 
 
 
 

Recognition

Since the first AHA Age-Friendly cohort launched in 2019, AHA Age-Friendly Health Systems Action Community participants have implemented the 4Ms Framework across a variety of care settings. Check the drop-down lists below for the names of teams that have achieved a level of “Age-Friendly” recognition.

  • "Age-Friendly Health Systems Participants" are hospitals and health care practices that have developed an action plan to showcase their commitment to putting the 4Ms into practice.
  • "Age-Friendly Health Systems – Committed to Care Excellence" have submitted counts of older adults reached with the 4Ms for at least three months.

Visit the Institute for Healthcare Improvement's website for a complete list of hospitals and practices recognized by the Age-Friendly movement.

    • AdventHealth Hendersonville - AdventHealth Biltmore Park Medical Group
    • AdventHealth Hendersonville - AdventHealth Family Medicine Brevard Medical Group
    • AdventHealth Hendersonville - AdventHealth Family Medicine Hendersonville Medical Group
    • AdventHealth Hendersonville - AdventHealth Forge Mountain Medical Group
    • AdventHealth Hendersonville - AdventHealth Hendersonville Hospital
    • AdventHealth Hendersonville - AdventHealth Integrative Medicine Medical Group
    • AdventHealth Hendersonville - AdventHealth Internal Medicine Dr. Drive Medical Group
    • AdventHealth Hendersonville - AdventHealth Laurel Park Medical Group
    • AdventHealth Hendersonville - AdventHealth Mills River Medical Group
    • AdventHealth Hendersonville - AdventHealth Parkway Medical Group
    • AdventHealth Hendersonville - AdventHealth South Asheville Medical Group
    • Advocate Aurora Health Care - Burlington
    • Advocate Aurora Health Care - Kenosha
    • Advocate Aurora Health Care - Racine
    • Advocate Aurora Health Care - Walworth
    • Atlantic Health System - Geriatric Assessment Center
    • Atlantic Health System - Morristown Medical Center
    • AtlantiCare Regional Medical Center
    • Avera Health System - Avera Creighton Hospital
    • Banner Health System - Banner University Medical Center-Tucson - Healthy Together Care Partnership
    • Banner Health System - Banner University Medical Center-Tucson
    • Barnes Jewish Christian Health System - Barnes Jewish Hospital-Stay Healthy Clinic - Barnes Jewish Hospital Primary Care Clinic
    • Bassett Healthcare Network - Bassett Medical Center
    • Bassett Healthcare Network - Fox Hospital
    • Bassett Healthcare Network - Cobleskill Regional Hospital
    • Bassett Healthcare Network - Little Falls Hospital - Northern Region
    • Bassett Healthcare Network - O’Connor Hospital
    • Beaumont Health - Beaumont-Royal Oak
    • Beechworth Health Service - Acute Centre
    • Beechworth Health Service - Residential Aged Care Program
    • Berkshire Health System - Berkshire Medical Center
    • Bibb Medical Center - Bibb Medical Associates BMC at Home
    • Bibb Medical Center - Hospital
    • Box Butte General Hospital
    • Brodstone Memorial Hospital
    • Cary Medical Center
    • Catholic Health - Mercy Hospital of Buffalo
    • Catholic Medical Center
    • Cedars-Sinai Medical Center
    • CHRISTUS St. Vincent Clinician Group - DeVargus Family Medicine
    • CHRISTUS St. Vincent Clinician Group - Entrada Family Medicine
    • CHRISTUS St. Vincent Clinician Group - Geriatric & Internal Medicine
    • CHRISTUS St. Vincent Clinician Group - Pojoaque Primary Care
    • CHRISTUS St. Vincent Clinician Group - Rodeo Family Practice
    • CHRISTUS St. Vincent Clinician Group - St. Michael's Family Medicine Center
    • CHRISTUS St. Vincent Clinician Group - St. Vincent Family Medicine Center
    • Clara Barton Hospital - Clara Barton Medical Clinic - Great Bend
    • Clara Barton Hospital - Clara Barton Medical Clinic - Hoisington
    • Clara Barton Hospital
    • Clara Barton Hospital - Primary Care Practice - Russell Family Medical Clinic
    • Coffey County Hospital
    • Coffey County Hospital - Coffey County Medical Center
    • Cork University Hospital - Geriatric Emergency Multidisciplinary Service
    • Covenant Health - St. Joseph Hospital Primary and Specialty Services Nashua
    • Covenant Health - St. Joseph Family Medicine - Hudson
    • Covenant Health - St. Joseph Family Medicine - Merrimack
    • Covenant Health - St. Joseph Family Medicine - Milford
    • Covenant Health - St. Joseph Hospital Specialty Care - South Nashua
    • Covenant Health - St. Joseph Hospital Rehabilitation Center
    • Cozad Community Health System - Cozad Community Hospital
    • Cozad Community Health System - Cozad Community Medical Clinic
    • Cozad Community Health System - Central Plains Home Health and Hospice
    • Cozad Community Health System - Meadowlark Pointe
    • Daiya Healthcare - (54 sites)
    • Dignity Health of the Central Coast - French Hospital Medical Center - ED department
    • Duke University Health System - Duke Regional Hospital
    • Edwards County Medical Center - Spearville Clinic - Rural Health Clinics
    • Edwards County Medical Center - Midway Clinic - Rural Health Clinics
    • Edwards County Medical Center
    • Eisenhower Health - Cathedral City North Primary Care
    • Eisenhower Health - North Palm Desert Primary Care
    • Fillmore County Hospital
    • Grace Cottage Hospital - Grace Cottage Family Health
    • Grady Health System - Grady Memorial Hospital
    • Greenwood County Hospital
    • Harlan County Health System
    • Hawaii Pacific Health - Geriatrics Consult Clinic
    • Hawaii Pacific Health - Skilled Nursing Facility
    • Hendricks Regional Health
    • Holy Cross Health - Holy Cross Germantown Hospital
    • Holy Cross Health - Holy Cross Hospital
    • Indiana University Health - IU Health Arnett Clinics - Senior Wellness Center
    • Indiana University Health - IU Health Arnett Hospital
    • Indiana University Health - IU Health Frankfort Hospital
    • Kearney County Health Services - Hospital
    • Kearney County Health Services - Minden Medical Clinic
    • Kearny County Hospital
    • Lexington Regional Health Center - Hospital Floor
    • Madonna Rehabilitation Hospital - Transitional Care Unit of Saint Jane de Chantal
    • Main Line Health - Bryn Mawr Hospital
    • Maine Health - Hospital Elder Life Program at Southern Maine Health Care
    • MaineHealth - Maine Medical Center Emergency Department
    • Marion General Hospital
    • Mass General Brigham - Martha's Vineyard Hospital Rural Health Clinic
    • Massachusetts General Hospital
    • Memorial Community Health System - Memorial County Hospital
    • Memorial Health System - Memorial Hospital
    • Middlesex Health - South 4
    • Morris County Hospital
    • Mount Sinai Health System - Mount Sinai Morningside
    • MUSC Health - Charleston Campus
    • MUSC Health - Medical University of South Carolina
    • Nebraska Hospital Association - Columbus Community Hospital
    • Nebraska Hospital Association - Johnson County Hospital
    • Nemaha County Hospital
    • Neosho Memorial Regional Medical Center - NMRMC Family Medicine Clinic
    • Neosho Memorial Regional Medical Center - Inpatient Units
    • New York City Health and Hospital Corporation - Geriatrics Clinic Bellevue Hospital
    • Northeast Health Wangaratta - Medical Ward
    • Northeast Health Wangaratta
    • Northeast Health Wangaratta - Northeast Health Wangaratta- Rehabilitation
    • Northeast Health Wangaratta - Thomas Hogan Rehabilitation Centre
    • Northwell Health - Glen Cove Hospital
    • Northwell Health - LIJ-Forest Hills Hospital
    • Olympic Medical Center
    • Perkins County Health Services - Perkins County Family Medical Center
    • Perkins County Health Services - Outpatient Orthopedic Clinic
    • Prime Health Care - St. Joseph's Medical Center
    • Providence St. Joseph Health System - Swedish Family Medicine - First Hill
    • Redington-Fairview General Hospital
    • Republic County Hospital
    • Rooks County Health Center - Rooks County Health Center
    • Rural Health Resources of Jackson County - Holton Community Hospital
    • Rural Health Resources of Jackson County - Family Practice Associaties - Holton
    • Rural Health Resources of Jackson County - Family Practice Associaties - Hoyt
    • Rural Health Resources of Jackson County - Family Practice Associaties - Wetmore
    • Saunders Medical Center - CAH Hospital and Rural Health Clinic
    • Sentara Healthcare - Sentara Martha Jefferson Hospital
    • Sheridan County Hospital - Sheridan County Health Complex
    • St. James Parish Hospital
    • St. Johns Riverside Hospital - Andrus Pavilion
    • St. Johns Riverside Hospital - Dobbs Ferry
    • St. Mary's Health System/Covenant Health - Outpatient - CSS Psychiatry Memory Clinic
    • Stanford Health Care - Geriatric Trauma Program
    • Summa Health - 4 South Summa Barberton Campus
    • Summa Health - Center for Senior Health
    • Summa Health - 5 North Summa Health Akron City Campus
    • Tidelands Health - Waccamaw Community Hospital
    • Tri State Memorial Hospital
    • Tri Valley Health System - Arapahoe Rural Health Clinic
    • Tri Valley Health System - Cambridge Memorial Hospital
    • Tri Valley Health System - Cambridge Rural Health Clinic
    • Tri Valley Health System - Indianola Rural Health Clinic
    • Unity Point Health - Buena Vista Regional Medical Center
    • University Health System - University Hospital - Surgical Trauma- ICU
    • University of California, San Diego - Jacobs Medical Center
    • University of California, San Diego - Jacobs Medical Center Critical Intensive Care Unit
    • University of California, San Diego - Thornton Hospital
    • University of Chicago Medicine SHARE Network - South Shore Senior Center
    • University of Rochester Medical Center - Highland Hospital Unit West 6
    • University of Rochester - Strong Memorial Hospital - Geriatric Fracture Center
    • University of Rochester - Strong Memorial Hospital
    • Veterans Health Administration - Manchester VA Medical Center - Community Living Center
    • Veterans Health Administration - VA Connecticut Healthcare System - Community Living Center
    • VillageMD - Village Medical at Home
    • Wake Forest Baptist Health System - Hospital - ACE Unit
    • Washington University School of Medicine - Geriatric Primary Care Clinic
    • White River Medical Center
    • Witham Health Services - Witham Hospital Extended Care Unit
    • Witham Health Services - Witham Outpatient Rehabilitation Services
    • Witham Health Services - Witham Primary Care Group
    • Yale New Haven Health System - Home Based Primary Care
    • Yale New Haven Health System - Yale Geriatric Primary Care
    • Yale New Haven Health System - Yale New Haven Hospital - Verdi 4W, Center for Restorative Care, East Pavillion 97
    • York General Health Care Services - York General Hospital
    • York Hospital - York Hospital Emergency Department and Provider Practices
    • AdventHealth Hendersonville - AdventHealth Biltmore Park Medical Group
    • AdventHealth Hendersonville - AdventHealth Family Medicine Brevard Medical Group
    • AdventHealth Hendersonville - AdventHealth Family Medicine Hendersonville Medical Group
    • AdventHealth Hendersonville - AdventHealth Forge Mountain Medical Group
    • AdventHealth Hendersonville - AdventHealth Hendersonville Hospital
    • AdventHealth Hendersonville - AdventHealth Integrative Medicine Medical Group
    • AdventHealth Hendersonville - AdventHealth Internal Medicine Dr. Drive Medical Group
    • AdventHealth Hendersonville - AdventHealth Laurel Park Medical Group
    • AdventHealth Hendersonville - AdventHealth Mills River Medical Group
    • AdventHealth Hendersonville - AdventHealth Parkway Medical Group
    • AdventHealth Hendersonville - AdventHealth South Asheville Medical Group
    • Advocate Aurora Health Care - Burlington
    • Advocate Aurora Health Care - Kenosha
    • Advocate Aurora Health Care - Racine
    • Advocate Aurora Health Care - Walworth
    • Atlantic Health System - Geriatric Assessment Center
    • Atlantic Health System - Morristown Medical Center
    • Avera Health System - Avera Creighton Hospital
    • Banner Health System - Banner University Medical Center-Tucson- Healthy Together Care Partnership
    • Barnes Jewish Christian Health System - Barnes Jewish Hospital - Stay Healthy Primary Care Clinic
    • Bibb Medical Center - Bibb Medical Associates/BMC at Home
    • Bibb Medical Center - Hospital
    • Box Butte Generial Hospital
    • Cary Medical Center
    • Catholic Health - Mercy Hospital of Buffalo
    • Cedars-Sinai Medical Center
    • Cork University Hospital - Geriatric Emergency Multidisciplinary Service
    • Covenant Health - St. Joseph Hospital Primary and Specialty Services Nashua
    • Covenant Health - St. Joseph Family Medicine - Hudson
    • Covenant Health - St. Joseph Family Medicine - Merrimack
    • Covenant Health - St. Joseph Family Medicine - Milford
    • Covenant Health - St. Joseph Hospital Primary and Specialty Care - South Nashua
    • Covenant Health - St. Joseph Hospital Rehabilitation Center
    • Covenant Health - St. Joseph Hospital Rehabilitation Center
    • Edwards County Medical Center
    • Greenwood County Hospital
    • Harlan County Health System
    • Hawaii Pacific Health - Geriatrics Consult Clinic
    • Indiana University Health - IU Health Arnett Hospital
    • Indiana University Health - IU Health Arnett Clinics - Senior Wellness Center
    • Kearney County Health Services - Minden Medical Clinic
    • Lexington Regional Health Center - Hospital Floor
    • Madonna Rehabilitation Hospital - Transitional Care Unit of Saint Jane de Chantel
    • Maine Health - Hospital Elder Life Program at Southern Maine Health Care
    • Mount Sinai Health System - Mount Sinai Morningside
    • Nebraska Hospital Association - Johnson County Hospital
    • Nemaha County Hospital
    • Northwell Health - Glen Cove Hospital
    • Northwell Health -LIJ - Forest Hills Hospital
    • Providence St. Joseph Health - Swedish Family Medicine - First Hill
    • Rooks County Health Center
    • Rural Health Resources of Jackson County - Holton Community Hospital
    • Saunders Medical Center - CAH Hospital and Rural Health Clinic
    • St. Johns Riverside Hospital - Andrus Pavillion
    • St. Johns Riverside Hospital - Dobbs Ferry
    • St. Mary's Health System/Covenant Health - Outpatient - CSS Psychiatry - Memory Clinic
    • Stanford Health Care - Geriatric Trauma Program
    • Summa Health - 4 South Summa Barberton Campus
    • Summa Health - Center for Senior Health
    • Summa Health - 5 North Summa Health Akron City Campus
    • Tidelands Health - Waccamaw Community Hospital
    • Tri State Memorial Hospital
    • University Health System - University Hospital - Surgical Trauma - ICU
    • University of Chicago Medicine SHARE Network - South Shore Senior Center
    • Veterans Health Administration - Manchester VA Medical Center - Community Living Center
    • Wake Forest Baptist Health System - Hospital (ACE Unit)
    • Washington University School of Medicine - Washington University Geriatric Primary Care Clinic
    • White River Medical Center
    • Witham Health Services - Witham Hospital Extended Care Unit
    • Yale New Haven Health System - Home Based Primary Care
    • Yale New Haven Health System - Yale Geriatric Primary Care
    • Yale New Haven Health System - Yale New Haven Hospital - Verdi 4W, Center for Restorative Care, East Pavillion 9
    • York General Health Care Services - York General Hospital
 
 
 

Pioneer health systems

Five pioneer U.S. health systems tested and implemented the 4Ms Framework in order to become an Age-Friendly Health System. Read their stories: to learn how they have successfully implemented the 4Ms at their organizations leading to reductions in patient length of stay and readmissions, improvement in patient family engagement and patient satisfaction, positive return on investments and improvement in patient safety.

 
 
 

Resources

Case Study

St. James Parish Hospital

Age-Friendly Care At a Critical Access Hospital

Despite limited resources and staff, St. James Parish Hospital used the 4Ms framework and successfully implemented and spread age-friendly concepts.

Chair File

Hochman_Rod_700x532

AHA Board Chair Discusses Age-Friendly Care

In this column, AHA Board Chair Rod Hochman, M.D., shares how Providence has used the age-friendly care framework for older adult patients.

Case Study

Older person looking at video call

Embedding an Age-Friendly Framework Into Practice

Banner Health used the 4Ms framework in caring for high-risk, older adult patients, which improved patient and provider satisfaction scores.

Case Study

Two people looking at a document

Age-Friendly Health Care Improves Value for Patients

This case study describes how a Cedars-Sinai Medical Center team used the 4Ms framework to reduce length of stay and improve outcomes for geriatric fracture patients.

Case Study

Becoming an Age-Friendly Health Care System

A member of Care New England, Kent Hospital opened an Adult Care for Elders unit to test the 4Ms Framework. Length of stay has decreased, and patient satisfaction has increased.

Case Study

Building an Age-Friendly Health System and Community

Rush University Health System began implementing the 4Ms Framework to improve the lives of patients, families, caregivers and employees.

Issue brief

Creating Value with Age-Friendly Health Systems

This Value Initiative issue brief highlights the 4Ms as a low-tech, value-based strategy to improve patient outcomes and experience for older adults.

Blog

Success Story: Implementing the 4Ms at Christiana Care

Nurses and other key stakeholders at Christiana Care embraced the 4Ms Framework, which became part of strategic planning efforts.

Guide

Putting the 4Ms into Practice

Learn more about the 4Ms Framework and how to use it in practice to become an Age-Friendly Health System in the Guide to Using the 4Ms in the Care of Older Adults.

Blog

Making Care Better and Friendlier for Older Adults

Personal story about caring for aging parents shared by Marie Cleary-Fishman, vice president of clinical quality at the AHA Center for Health Innovation.

4Ms Framework for an Age-Friendly Health System


Rush Center for Excellence in Aging highlights using the 4Ms to create an Age-Friendly Health System.

What Is an Age-Friendly Health System?

Mary Tinetti, M.D., chief of geriatrics at Yale School of Medicine and Yale–New Haven Hospital, describes what it means to be an Age-Friendly Health System.

How the 4Ms Improve Care for Older Adults

This video from the John A. Hartford Foundation outlines how to provide the best care possible for older adults.


Partners:

The John A. Hartford Foundation
The Institute for Healthcare Improvement (IHI)
Catholic health ministry of the United States