Hospital Adoption of Models of Care and Practices for Older Adults and Its Impact

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DESCRIPTION (provided by applicant): Older adults, the fastest growing segment of the population, are more prone to acute illnesses, and account for a disproportionately high number of hospital acute care admissions and hospital days. They are also particularly at risk for adverse events such as hospital acquired infections, delirium, falls, and pressure ulcers during inpatient hospitalization. To improve care delivery for older adults and reduce risk of adverse outcomes, several models of care targeting hospitalized older adults have been developed. These models include dedicated units or teams for older adults, delirium prevention models, and transitional care programs to prevent lapses when patients are discharged from the hospital; they have been shown to be effective in improving patient safety and quality of care. Although these models and practices may improve quality of care among older adults, little is known about how hospitals across the country have adopted them in their care delivery systems. As increasing attention has been placed on hospital performance in patient care, understanding how hospitals implement care models and practices of care to improve quality and how these models and practices relate to health outcomes would be an important step toward guiding further efforts to transform care. In this study, we will develop a hospital survey tool to characterize services and processes of care adopted by hospitals to deliver care sensitive to older adults. We will apply this tool to a large number of hospitals across the country, utilizing n already established network-the Nurses Improving Care for Health system Elders (NICHE) network of over 400 hospitals. Using the survey data, we will develop a measure to describe the degree to which hospitals have adopted models and practices for older adults. We will compare hospitals on this measure and examine its relationship with patient outcomes. Such measures may also allow for the examination of regional variations and variations over time.