My father died three years ago in a low-quality nursing home. He was there because he needed to be there so that everyone could be safe. After years of physical and emotional decline, my sister and I convinced my father’s wife to engage hospice in the nursing home. He had one of those peaceful deaths you read about — holding his wife’s hand, passing in his sleep just hours after my sister and I arrived to kiss him goodbye.
His death was serene. His life in the nursing home was not. My dad and I were not close, but since his death I have carried the sadness that none of us could figure out how to ask him what mattered most to him at the end of his life. He ended up dying a “good death,” but what might have made a difference in how he lived those last days, weeks, months, and years of his life?
Hearts and Minds
I was thinking of my father at the recent launch of IHI’s new initiative, called Creating Age-Friendly Health Systems, to develop systems that measurably improve care for older adults while lowering costs. Funded by The John A. Hartford Foundation, IHI is working with five pioneering health systems to determine how to reliably deliver the best care to older adults. “Age-friendly” health care ensures that older adults are satisfied with their care; decreases a collection of healthcare-related harms common to older adults; and reduces the use of unnecessary hospital care.
But The John A. Hartford Foundation has challenged IHI and our health system partners engaged in this initiative to do more than improve the quality of health care for a select subpopulation. They have established the bold goal of spreading age-friendly care to more than 1,000 health systems across the US by 2020.
Applying the discipline of the science of improvement will help us build the age-friendly health system we’re imagining, but we will need more than rapid-cycle testing and spread strategies to get us where we need to go. To achieve the goal of spreading age-friendly care throughout the US, we’ll also need a social movement — what Marshall Ganz defines as an “organized collective action challenging the status quo.” This means working together to reimagine and transform health care.
We had this in mind at the first workshop of the Creating Age-Friendly Health Systems initiative when we asked participants to engage with their open hearts and minds. With the world’s leading experts on geriatrics and patient safety also in attendance, we asked each person, “Why are you here?” Instead of maintaining the typical professional distance from our work, we each shared why we chose to spend time on improving care for older adults rather than on other aspects of the health care system. Some people told stories of their early exposure to care of the elderly, and how it shaped their career choices. Others talked about navigating care systems for their own loved ones, and how that inspires them to improve their own system.
Why am I committed to building age-friendly health systems? Because I want Ella, my thirteen-year-old daughter, to have better experiences with the health care system than those of her parents or grandparents. I want her — and everyone’s daughters and sons — to one day soon be sure that our health care providers know what matters most to all of us. I intend to be part of the social movement to help people live life as fully as possible throughout their lives.
Leslie Pelton is Director for IHI’s Creating Age-Friendly Health Systems initiative.
You may also be interested in:
WIHI on April 20, 2017: Creating Age-Friendly Health Systems
Health Affairs: Age-Friendly Health Systems: How Do We Get There?