Rush | Illinois: Rush Center for Excellence in Aging Improves Care Delivery for Older Adults

About Rush

For over 180 years, Rush has been improving the health of individuals across Chicago’s community. Today, it is a leading academic health system with hospitals in Aurora, Chicago and Oak Park, an extensive provider network and more than 30 clinical locations across the greater Chicago area. Rush’s health system is committed to a care model that encompasses innovation, collaboration, accountability, respect and excellence to deliver high-quality, safe patient care.

Rush Center for Excellence in Aging Improves Patient Safety

The Rush Center for Excellence in Aging (CEA) applies lessons learned from research to clinical and community settings to improve how health professionals deliver care for older adults. CEA’s health care providers collaborate across six core areas: research, older adult and family care, education, community health equity, health policy and student engagement. The ultimate goal is to improve the health and well-being of aging patients, including improving their cognitive health and addressing health disparities, while also supporting their families.

Rush’s CEA plays a leading role in driving innovation and improving health and safety outcomes for older adults across the system. Rush has integrated the Age-Friendly Health Systems framework to ensure that age-friendly care is a core patient safety priority from C-suite-level executives to front-line care providers.

Rush has also integrated its older adult-focused care framework into academic coursework to prepare the next generation of age-friendly professionals. The Center for Excellence in Aging runs the Schaalman Senior Voices fellowship program, enabling students and faculty to engage in an age-friendly health system project to help inform research, practice, policy and curricula. Rush also prioritizes teaching key geriatric principles such as frailty and comprehensive geriatric assessments, across medical disciplines like oncology.

The 4Ms Framework

Age Friendly is a model for providing safe care for older adults over 65, empowering them to live safe and happy lives.

At the core of Age Friendly is the 4Ms Framework:

• What Matters: Asking what matters most to older patients, such as being able to ride a bike again or attend a grandchild’s sporting events. The Rush team strives to align the patient’s care plan with their health goals and preferences so they can do what matters most to them.
• Medication: Ensuring that older adults are on an age-friendly medication adherence plan that does not negatively impact their mobility, cognitive health or what matters to them.
• Mentation: Focusing on a patient’s mental activity, which is critical to overall health and safety. For age-friendly care, it’s important to identify, treat and manage conditions like dementia, depression and delirium.
• Mobility: Ensuring older adults experience safe mobility during hospitalization is important for maintaining independence and encouraging healing.

Rush has built the 4Ms into emergency care, annual wellness visits and its college of nursing and medical school curricula. By keeping these 4Ms front of mind for every member of the care team, from physicians and nurses to social workers and administrators, Rush prioritizes the wellbeing of the patients it serves, even contributing to lowering the system’s average length of stay for a patient and helping more older individuals stay out of the hospital.

Key Lessons for Other Health Systems to Implement Age-Friendly Care

Rush’s age-friendly framework can be incorporated into other care systems ranging from small rural clinics to large urban health systems. Rush encourages other health leaders to start the conversation, ask others for advice and start small.

Lessons Rush has learned to deliver safer, more coordinated care for older adults include:

• Start with Self-Assessment: Review care and safety practices — floor by floor and practice by practice — to identify the critical issues affecting older adults and how to serve them better. Once issues have been identified, providers and systems can start small by addressing one M or review all four.
• Engage All Team Members from C-Suite to Frontline: For success, all members of the hospital team must be committed to achieving the same vision. By having connectivity and consensus among health care providers, patients and their families, systems can support age-friendly care throughout hospital stays and during a patient’s transition back home.
• Care for Caregivers: Rush established a “Caring for Caregivers” program based on the understanding that supporting caregivers improves patient care.

To improve the safety outcomes of older adults, age-friendly care should be prioritized and fully integrated into a health system’s broader patient safety strategy.