Disruptive Innovation: Scale and Spread of the 4Ms Framework to the Convenient Care Setting to Promote Quality Care for Older Adults.

Abstract

This article addresses nursing leader-led innovative care disruption with implementation strategies to scale and spread the Age-Friendly Health Systems (AFHS) movement from acute and ambulatory settings into convenient care. Quality improvement and implementation science methods guided the translation of age-friendly 4Ms care, an evidence-based approach to safe, high-quality care for older adults: What Matters, Medication, Mentation, Mobility. Primary drivers included suggested standardization of workflow and creating a culture change about care of older adults in convenient care. Results included an increase in 4Ms care from 261 visits in Q4 of 2020 to 13,657 visits in Q4 2022, a 52-fold increase. This led to increased patient awareness of age-friendly care, identification of patients at risk for depression, dementia, inappropriate medications, and mobility issues, and integration of "What Matters" to the older adult in the plan. This article highlights the importance of age-friendly 4Ms care delivery in urgent care settings with innovative care disruption strategies to spread age-friendly care. Home care and community agencies can also adopt a scale up and spread approach to integrate the 4Ms into practice, reliably implement the 4Ms to improve safety and experience outcomes, become recognized as AFHS, and ensure translation of evidence-informed care into practice.