A elderly patient is treated by a doctor.
An increasing number of older patients are being treated by nurse practitioners and physician assistants in MinuteClinic locations across the country.

Caring creatively for an aging population

Frances Payne Bolton School of Nursing works with The John A. Hartford Foundation, Institute for Healthcare Improvement to enhance Age-Friendly care at MinuteClinic locations

The Frances Payne Bolton School of Nursing at Case Western Reserve University is working with MinuteClinic, the retail medical clinic of CVS Health, and the Institute for Healthcare Improvement to enhance care for the increasing number of older patients treated by nurse practitioners and physician assistants in MinuteClinic locations across the country.

The project is being supported with a one-year planning grant of up to $945,000 from The John A. Hartford Foundation as part of its Age-Friendly Health Systems initiative.

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 (AHA) and the Catholic Health Association of the United States (CHA).

“The Age-Friendly Health Systems initiative has become a movement to transform care for all of us as we age, thanks to our collaboration with the Institute for Healthcare Improvement and our other partners,” said Terry Fulmer, president of The John A. Hartford Foundation. “Through this new partnership with Case Western Reserve and CVS Health’s MinuteClinic, we have the tremendous opportunity to spread and scale the principles of Age-Friendly care to even more older adults in even more communities.”

Mary Dolansky photo
Mary Dolansky

Implementing Age-Friendly principles

A Case Western Reserve team will work with MinuteClinic to plan the implementation of the “4Ms” (What Matters, Medication, Mentation and Mobility), the Age-Friendly initiative’s cornerstone framework designed to be equally effective in acute care and ambulatory settings.

The team, with advising from IHI, will incorporate 4M-specific assessments and interventions into existing electronic medical record-keeping and help train staff.

Mary Dolansky, associate professor and director of the QSEN (Quality Safety Education for Nurses) Institute at the nursing school, will lead the project. She said her team will provide expertise in gerontology, implementation and educational technology.

The partners plan to identify MinuteClinic sites across the country that serve a significant aging adult population as pilot locations for Age-Friendly care.

Ultimately, the goal is to bring this Age-Friendly care to all 1,100 MinuteClinic locations nationwide and train more than 2,900 nurse practitioners and physician assistants.

“Since its inception, MinuteClinic has offered care through more than 42 million patient visits with high marks on customer satisfaction,” said Sharon Vitti, senior vice president of CVS Health and executive director of MinuteClinic. “Through our partnership with Case Western Reserve and IHI, we are thrilled to have the opportunity to further enhance quality, Age-Friendly care within our clinics.”

Health systems join ‘Action Community’

As part of the project, representatives from both Case Western Reserve and MinuteClinic, along with 72 other organizations, are also participating in the Age-Friendly Health Systems Action Community, launched in September.

“Along with The John A. Hartford Foundation, IHI understands the importance of ensuring that every older adult receives the care that prioritizes health challenges that often matter most to older adults, such as mobility and managing medications,” said Kedar Mate, IHI’s chief innovation and education officer. “It is particularly important that these areas are addressed across the care continuum, from community-based clinics to hospital settings.

“By engaging in the Age-Friendly Health System Action Community, Case Western Reserve and MinuteClinic are poised to lead the way in supporting Age-Friendly care in retail ambulatory care settings.”

The Age-Friendly initiative addresses some very specific considerations for serving an aging group of patients, said Evelyn Duffy, associate director of the University Center on Aging and Health and faculty coordinator of the Geriatric Nurse Practitioner Program at the nursing school.

That means understanding that a provider’s plan for care may not initially align with the older patient’s ideas, she said. For example, a patient may state their desire to spend time with their grandchildren and choose to not undergo an elective procedure.

“So what matters most to the patient may surprise the provider and upend the plan they had so carefully crafted,” Duffy said. “But the result is one that better reflects the values and concerns of the older adult.”

For more information, contact Mike Scott at mike.scott@case.edu.