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Leveraging the EHR to Promote Age-Friendly Care in Hospitals (LEAF)

Award Number: R01AG090487
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 01/01/2025
PERIOD OF PERFORMANCE END DATE: 11/30/2029

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Leveraging the EHR to Promote Age-Friendly Care in Hospitals (LEAF) - Project Summary: The ultimate goal of this study is to improve hospital care for older adults. Maintaining cognition and physical function are critically important goals to most older patients, and yet our current hospital care results in 40% losing physical function and 18-50% suffering from delirium. The 4Ms Framework (What Matters Most, Mentation, Medications, and Mobility) is an evidence-based framework of care which reduces healthcare costs, hospital-acquired delirium, and functional decline. However, this framework and similar national geriatric quality improvement (QI) programs for hospitalized older adults (Geriatric Emergency Department Accreditation, Nurses Improving Care for Healthsystem Elders (NICHE), Geriatric Fracture Society and Geriatric Surgery Verification) have seen limited adoption in hospitals. One obstacle to dissemination is the lack of standardized integration of the 4Ms into electronic health records (EHRs) in a way that is easily used by staff for clinical decision making. Leveraging the EHR to Promote Age-Friendly Care in Hospitals (LEAF) will bring together interdisciplinary stakeholders from these five national geriatric QI programs and front-line hospital staff to design an EHR navigator that collates 4Ms information and is easily visible to all healthcare team members. The “4Ms Navigator” will use behind the scenes “bookmarks” to actively collate geriatric assessments and information in real time in one place for clinical use. This will prevent information loss between healthcare encounters and promote communication during hospitalizations. (Aim 1) We will evaluate current best practices, perform workflow analyses, and prioritize elements for the navigator design using nominal group theory techniques. The Consolidated Framework for Implementation Research (CFIR) will be used to guide implementation at the pilot health system. The pilot data will be used to refine the 4Ms Navigator and then (Aim 2) implement it at 4 other healthsystems with diverse geriatric QI programs. We will track the implementation support needed to achieve adoption across the hospitals (Aim 2a). Aims 2b and 2c will track the impact on care quality (hospital length of stay, 30-day rehospitalizations, and emergency department admission rates for older patients). In addition to these current quality measures, the 4Ms Navigator design stakeholder group will also discuss and design novel electronic clinical quality measures (eCQMs) for hospitalized older adults that consider their unique patient centered goals, such as maintaining cognition and physical function. Finally, we will test the reliability and validity of the 4Ms Navigator for eCQM abstraction. Conclusion: This project will engage stakeholders throughout the building and testing of essential clinical EHR infrastructure and improve the abstraction of 4Ms information for quality assessment. This study will gather data on adoption, adaption, implementation needs, and clinical outcomes to prepare for national dissemination. Developing EHR infrastructure that meets the criteria of multiple national geriatric QI programs and promotes adoption of high quality clinical care is novel and will spur better care for millions of older adults.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $785,128 )
2026	2026	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Aging Research	002	2	3/2/2026	NON-COMPETING CONTINUATION	$78,514
2026	2026	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Aging Research	001	2	2/5/2026	NON-COMPETING CONTINUATION	$706,614
2026	2025	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Aging Research	000	1	2/5/2026	NEW	$0
														Subtotal = $785,128

Issue Date FY: 2025 ( Subtotal = $849,993 )
2025	2025	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Aging Research	000	1	12/31/2024	NEW	$849,993
														Subtotal = $849,993

Grand Total All Awards = $1,635,121

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Leveraging the EHR to Promote Age-Friendly Care in Hospitals (LEAF)

Award Number: R01AG090487

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 01/01/2025

PERIOD OF PERFORMANCE END DATE: 11/30/2029

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