Age-Friendly Care, Banner University Medical Center-Phoenix

Abstract

Background: The older adult population in the United States is growing rapidly, and this trend demands our urgent attention. By 2030, there will be more older adults than children under 18 for the first time in history, and in Arizona, nearly one in four residents will be aged 65 or older (U.S Census Bureau, 2018). This shift will undoubtedly lead to a significant increase in the demand for care for older adults, placing considerable pressure on the healthcare system. Objectives: This quality improvement project aims to identify the barriers and analyze the challenges impacting patient care delivery at Banner University Medical Center-Phoenix (BUMCP), an Age-friendly care center, and develop potential solutions to address these issues, focusing on the required criteria outlined by the Geriatrics Emergency Department Accreditation (GEDA) and Center for Medicare and Medicaid Services (CMS) measures. Methods: We identified 65 BUMCP employees who have managed older adults and engaged with the ACE unit, where age-friendly care is consistently implemented. The employees include physicians, surgeons, other healthcare providers, nurses, case managers, social workers, physical therapists, nutritionists, pharmacists, and administrators. We engaged these employees in interviews using questionnaires to uncover operational challenges and barriers to care, as well as to gain insights into their experiences and gather direct feedback. This information was subsequently summarized using the Qualtrics platform to highlight areas needing improvement and potential solutions. Results: The main barriers to care include patient complexities (53%) and time constraints, affecting 80% of respondents, with cognitive impairment and mobility limitations being significant issues. Challenges with end-of-life care and advance directives are also noted, impacting 82% of respondents to varying degrees. Conclusion: The Age-friendly care initiatives have demonstrated effectiveness in addressing the distinctive needs of older adults; however, they are not without considerable challenges.