Implementation of age-friendly health systems within the Veterans Affairs healthcare system for veterans 65 or older Other
Conditions
Interventions
To improve clinical outcomes for older adult veterans, four evidence-based practices will be implemented across the Veterans' Integrated Service Network (VISN-4) in a type 3 hybrid effectiveness-imple
Sponsors
Department of Veterans Affairs
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Community-dwelling veteran 2. Age 65 or older either receiving a treatment targeted by one of our EBPs (for example, are referred for a surgical procedure or prescribed a high-risk medication), or have risk factors targeted by one of our EBPs ( for example, carrying a diagnosis of dementia or with functional impairments that prevent completion of activities of daily living) 3. Each EBP has additional eligibility criteria specific to its purpose: 3.1. Surgical Pause, will include anyone with a score indicating frailty who is also considering an elective surgery 3.2. EMPOWER, Veterans must have been receiving a high-risk medication for at least 90 of the 120 days prior to implementation 3.3. TAP, Veterans must have a diagnosis of dementia 3.4. CAPABLE, Veterans must have 1 Activity of Daily Living or 2 Instrumental Activities of Daily Living deficiencies
Exclusion criteria
Exclusion criteria: 1. Receipt of hospice care or being in long-term nursing home care 2. Veterans with severe mental illness will be excluded from EMPOWER 3. Veterans without a caregiver will be excluded from TAP
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Data collected from the following nationally available datasets: VA administrative health records stored in the VA Corporate Data Warehouse, and Medicare claims records 1. The proportion of all eligible Veterans who received one (or more) of our interventions per clinical site, data collected monthly 2. The proportion of all eligible Veterans who are referred to the interventions, data collected monthly 3. The number of "facility-free days," or the number of days older Veterans remain alive and outside the hospital or nursing home, data collected annually | — |
Secondary
| Measure | Time frame |
|---|---|
| Measured monthly using the VA administrative health records stored in the VA Corporate Data Warehouse, and Medicare claims records: 1. Postoperative mortality 2. Length of stay (at hospital and ICU) 3. Index hospital discharge disposition Intervention specific outcome measures: 4. "Surgical Pause": Readmission rates 5. "EMPOWER": 5.1. Number of cessation prescription fills for target medication reduction 5.2. Number of mailed brochures to eligible Veterans 6. TAP and CAPABLE: 6.1. Hospitalization and nursing home placement rates 6.2. Percentage of trained occupational therapists and registered nurses delivering the program | — |
Countries
United States of America
Contacts
Public ContactTanisha Dicks
Outcome results
None listed