Aurora Medical Center, Kenosha

Advocate Health (AH) is on a journey to implement the 4Ms framework across all 25 Midwest hospitals and achieve Level 1 and 2 Age-Friendly recognition by 2025. Aurora Medical Center Kenosha (AMCK) began this journey with the first AH Age-Friendly cohort from March to May 2022. The team at AMCK, including Age-Friendly Champions Susan Perusich, Aurora Smith, and Christa Oechler, focused on identifying gaps in 4Ms care and developing plans to address each "M."

From March to June 2022, the champions educated the staff of Med Surg 3 on the system standards for assessing and acting on each of the 4Ms. From July to September 2022, Med Surg 3 implemented the 4Ms framework and used Plan-Do-Study-Act (PDSA) cycles to identify and close gaps. One key gap identified was in assessing patients' mobility. The use of the Comprehensive Mobility Evaluation Tool (CMET) was initially 96% effective, but clinicians did not always perform the tool correctly. To address this, AMCK created a competency validation process and a communication workflow to ensure proper use of CMET results. As a result, CMET screening improved from 96% to 98%, and the average "admission to out of bed" time decreased from 12.26 hours to 9.32 hours and is now just under 8 hours.

Recognizing older adult mobility as a key quality improvement opportunity, the AMCK Mobility team (Nursing and Rehab services) initiated a healthy competition among staff and departments to get patients up and moving. The Mobility Challenge, which rewarded departments with a traveling trophy and monthly themed treats, led to increased patient mobility, with 426 miles walked from December 2022 to October 2023. This increase in mobility reduced complications from bed rest and lowered the readmission rate from 11.7% to 10%.

In May 2022, Kenosha achieved Level 1 Age-Friendly Recognition, and by November 2022, they reached Level 2 Age-Friendly Committed to Care Excellence Recognition. Since then, Kenosha has been working on sustaining and improving 4M care on Med Surg 3 and expanding these practices to other units at AMCK.