Building Age-Friendly Health Systems

When Susan Shelton’s 99-year old father, Chet, was a patient at the Anne Arundel Medical Center (AAMC), he received care that was tailored specifically to his needs. This unique experience is all due to AAMC’s Age-Friendly Health Systems initiative. The initiative aims to significantly improve care and quality of life for older adults through personalized, patient-centered treatment.

In 2017, the Anne Arundel Medical Center received a $250,000 grant from The John A. Hartford Foundation to co-design and test the Age-Friendly Health Systems prototype. More than 45 percent of all patients admitted to the AAMC are at least 65 years old. The Age-Friendly Health Systems initiative is based on the concept of person-centered care, which places an emphasis on designing care based on a person’s own preferences and goals. Lil Banchero, Senior Nursing Director, oversees the initiative at AAMC. When asked about this innovative initiative she says, “Age-Friendly Health Systems will allow us to focus on what really matters to our patients and make sure those things happen reliably for every older adult and their caregivers.” The age-friendly model takes a team-based approach to increase both patient and provider satisfaction, reduce the length of stay and decrease hospital denials. The team includes a physician, care manager, and nurse, all of whom work together to discuss what matters most to the patient. “All patients and families deserve this partnership and kind care,” Lil says. The Age-Friendly Health Systems initiative was launched in the Acute Care for Elders unit at AAMC. As a result of this initiative, Lil reports that the hospital has seen an increase in patient satisfaction for those receiving care in this unit. Patient satisfaction was 83 percent in the first quarter of the fiscal year 2018—up from 70 percent in the fiscal year 2017.

During Chet’s stay in the hospital, Susan noticed how accommodating the nursing staff were to her father’s needs. For example, her father doesn’t like to be cold. In response, nurses always made sure he had extra heated blankets. To Susan, the most striking example of the person-centered care her father received was during an episode of delirium. Nurses contacted Susan, who was able to talk to him on the phone, calm him down, and then stay the night with him at the hospital. Reflecting on that day, Susan stated, “The staff really understands how to work with older adults and their caregivers.” Witnessing first-hand how impactful a person-centered approach to care was on her father’s hospital stay inspired Susan to bring that model into the community.

In addition to her role as caregiver for her Dad, Susan is the Program Director for the Assisted Living Program at the Anne Arundel County Department of Aging and Disabilities. In her position, Susan works closely with the small, community-based assisted living facilities in the county. Susan recognized how a person-centered approach to care could be applied to assisted living to promote the Age-Friendly Health Systems initiative. Working together with her team, Susan developed MY STORY©, a tool designed to promote person-centered care by highlighting the individual needs and preferences of a person receiving care.

The Assisted Living Program conducted a pilot program using the MY STORY© tool with 14 small (4-16 bed) community-based assisted living facilities in Anne Arundel, Howard, and Baltimore counties. The program was well-received by caregivers, who reported that the MY STORY© tool allowed them to learn what was important to each resident and create meaningful relationships between themselves and their residents beyond their basic job duties. Family members and residents enjoyed the personalized care and increased social interactions between residents and caregivers. Assisted living providers appreciated the ease with which the MY STORY© tool could be incorporated into their daily operations and that there were no additional costs involved with using the tool in their facilities.

The initial goal of the pilot program was to expand the use of the MY STORY© tool to reach 900 members in the community. The program has been highly successful and has actually reached about 1,300 older adults residing in assisted living facilities, skilled nursing homes, hospice care facilities, and private homes of those still living independently in the community. The positive impact has reached across the continuum of care, as the MY STORY© tool travels with a resident when they require a visit to the hospital or stay in a rehabilitation facility. The MY STORY© tool has been especially impactful for residents who are living with dementia. It has been used as a communication tool for hospital staff and has resulted in at least two occasions where hospital staff members were able to avoid the use of physical restraints by utilizing this MY STORY©.

In 2018, The Anne Arundel County Department of Aging and Disabilities was honored to receive a Merit Award from the National Mature Media Awards, an organization that recognizes the nation’s best educational programs for older adults. Susan Shelton and Lil Banchero continue to work together to promote the Age-Friendly Health Systems initiative through the use of the MY STORY© tool. New partnerships with other long-term care providers in Anne Arundel County are continually being established. The MY STORY© tool has been a great way to spread the word about the benefits of creating an Age-Friendly Health System