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扩大和推广关爱老年人的护理服务:美国退伍军人事务部全国关爱老年人行动社区的早期经验教训。

Scaling and spreading age-friendly care: Early lessons from the VA National Age-Friendly Action Community.

作者信息

Schwartz Andrea Wershof, Munro Shannon, Echt Katharina V, Mirk Anna, Solberg Laurence M, Wozneak Kimberly

机构信息

Department of Veterans Affairs, New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA.

Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital; Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Am Geriatr Soc. 2025 Feb;73(2):583-591. doi: 10.1111/jgs.19321. Epub 2025 Jan 9.

Abstract

BACKGROUND

The Age-Friendly Health System (AFHS) initiative seeks to improve care for older adults through assessing and acting on the 4Ms (What Matters, Medication, Mentation, Mobility). The Department of Veterans Affairs (VA) joined the initiative in 2020, and from 2022 to 2023, VA led its first Age-Friendly Action Community, a 7-month online educational series to teach clinicians about implementing the 4Ms across VA care settings.

METHODS

The VA Action Community was designed to spread awareness about Age-Friendly care for older Veterans, improve interprofessional team knowledge for providing care guided by the 4Ms, and support AFHS implementation across multiple care settings. The VA Action Community included online synchronous webinars, Community of Practice coaching calls, and office hours. A learner experience questionnaire was administered at the completion of the Action Community.

RESULTS

Totally 186 care teams enrolled in the VA Action Community, representing 78/171 (45.6%) VA medical centers (VAMCs), across 36 US states and 20 types of care settings. Participants reported high rates of satisfaction and confidence in their ability to apply the knowledge and skills learned. Overall, 58 Action Community teams earned Level 1, Participant recognition, and 43 teams also earned Level 2, Committed to Care Excellence recognition from the Institute for Healthcare Improvement.

CONCLUSIONS

The VA Action Community facilitated learning about the 4Ms, supported interprofessional teams in earning AFHS recognition, and offers a promising model for spreading AFHS in other large health systems. Further work is underway to evaluate the impact of this educational experience on clinical process and outcomes measures.

摘要

背景

老年友好型医疗系统(AFHS)倡议旨在通过对“4M”(重要事项、药物治疗、认知能力、活动能力)进行评估并采取行动,改善对老年人的护理。美国退伍军人事务部(VA)于2020年加入该倡议,并在2022年至2023年期间,领导了其首个老年友好型行动社区,这是一个为期7个月的在线教育系列,旨在向临床医生传授如何在VA的各个护理环境中实施“4M”。

方法

VA行动社区旨在提高对老年退伍军人的老年友好型护理的认识,提高跨专业团队在以“4M”为指导提供护理方面的知识,并支持在多个护理环境中实施AFHS。VA行动社区包括在线同步网络研讨会、实践社区指导电话会议和答疑时间。在行动社区结束时进行了学习者体验问卷调查。

结果

共有186个护理团队参加了VA行动社区,代表了美国36个州的78/171(45.6%)VA医疗中心(VAMC)以及20种护理环境。参与者对应用所学知识和技能的能力满意度很高且信心十足。总体而言,58个行动社区团队获得了1级参与者认可,43个团队还获得了医疗改进研究所颁发的2级卓越护理认可。

结论

VA行动社区促进了对“4M”的学习,支持跨专业团队获得AFHS认可,并为在其他大型医疗系统中推广AFHS提供了一个有前景的模式。目前正在开展进一步工作,以评估这种教育体验对临床过程和结果指标的影响。

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