We all deserve safe, effective, patient-centered care delivered reliably in every setting - especially as we age.

Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement in partnership with the American Hospital Association and the​ Catholic Health Association of the United States. 

The goal of the initiative is to develop an Age-Friendly Health Systems framework and rapidly spread to 20 percent of U.S. hospitals and health systems by 2020.​​

What is an Age-Friendly Health System?

An age-friendly health system will measurably improve the quality of care for older adults and optimize value for health systems. It is a health care system in which:

  • Older adults get the best care possible;
  • Healthcare-related harms to older adults are dramatically reduced;
  • Older adults and their families are satisfied with their care; and
  • Value is optimized for all.

The "4Ms"

The 4Ms Age-Friendly framework is both evidence based and able to be put into practice reliably in health care settings:

  • What Matters: Know and align care with each older adult's specific health outcome goals and care preferences including, but not limited to end-of-life care, and across settings of care.
  • Medication: If medications are necessary, use Age-Friendly medications that do not interfere with What Matters, Mobility, or Mentati​on across settings of care.
  • Mentation: Prevent, identify, treat, and manage dementia, depression, and delirium across care settings.
  • Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters.

Pioneering Health Systems

In 2017, five pioneering U.S. health systems stepped forward to test ideas and learn what it takes to be an Age-Friendly Health System:

Action Communities

In September 2018, over 100 teams from health systems across the U.S. began working together in the Age-Friendly Health Systems Action Community, to rapidly scale-up specific 4M changes over a seven-month period. This Action Community will conclude in March 2019, but more are planned. 

To join a future Action Community, email AFHS@ihi.org.

What We're Learning

  • The American Hospital Association's Huddle for Care site shows examples of how teams are implementing the 4Ms
  • The Catholic Health Association publishes quarterly Health Progress articles on age-friendly care

        Other articles include:

For a complete list of publications and news coverage, click here.


For More Information

To stay informed about the initiative visit IHI's website at www.ihi.org/AgeFriendly

To join the Age-Friendly Health Systems movement, please email AFHS@ihi.org

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