Establishing First Age-Friendly Health System Tele-Palliative Care Clinic – Facilitators, Challenges, Lessons Learned to Improve Care for Rural, Older Veterans.

Age Friendly Health Systems (AFHS) promote geriatric best practices to improve healthcare quality, minimize harms and support older adults' care preferences. AFHS-designated clinics consistently address the Geriatric 4Ms: Mentation, Mobility, Medication, and What Matters Most. The VA Eastern Colorad...

Full description

Bibliographic Details
Published in:Inquiry (00469580) Vol. 62; pp. 1 - 14
Main Authors: Hartz, Stephanie, Garbin, Alexander, McGuire, Courtney, Steagall, Jill, McCauliff, Jocelyn, Nearing, Kathryn Allen
Format: pictorial research tables/charts Journal Article
Published: Sage Publications Inc. 7/8/2025
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=186527741&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 186527741
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00469580
        INQ
      jtl: Inquiry (00469580)
      issn: 00469580
      maglogo: Y
    pubinfo:
      dt: 7/8/2025
      vid: 62
      pid: 344
      pub: Sage Publications Inc.
      place: Thousand Oaks, California
    artinfo:
      ui:
        186527741
        186527741
        186527741
        10.1177/00469580251352727
        186527741
      ppf: 1
      ppct: 13
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Establishing First Age-Friendly Health System Tele-Palliative Care Clinic – Facilitators, Challenges, Lessons Learned to Improve Care for Rural, Older Veterans.
      aug:
        au:
          Hartz, Stephanie
          Garbin, Alexander
          McGuire, Courtney
          Steagall, Jill
          McCauliff, Jocelyn
          Nearing, Kathryn Allen
        affil: Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
      sug:
        subj:
          Telemedicine
          Palliative Care Methods
          Quality Improvement
          Rural Health Services
          Veterans In Old Age
          Age Specific Care
          Human
          Aged
          Quality of Health Care
          Interprofessional Relations
          Program Implementation
          Travel
          Descriptive Statistics
          Colorado
          Race Factors
          Ethnic Groups
          Minority Groups
          Female
          White Persons
          Male
          Caregivers
          Psychosocial Aspects of Illness
          Severity of Illness
          United States Department of Veterans Affairs
          Gerontologic Care
          Aged: 65+ years
          Female
          Male
      ab: Age Friendly Health Systems (AFHS) promote geriatric best practices to improve healthcare quality, minimize harms and support older adults' care preferences. AFHS-designated clinics consistently address the Geriatric 4Ms: Mentation, Mobility, Medication, and What Matters Most. The VA Eastern Colorado Health Care System tele-Palliative Care clinic achieved AFHS Level 1 and 2 recognition in 2021, becoming the first AFHS-designated telemedicine clinic in the nation. An interprofessional team and older Veterans guided planning and implementation. Using existing staff and clinic workflows, we consistently addressed the Geriatric 4Ms during visits. Specific metrics include: (1) AFHS Level 1 and 2 recognition, (2) maintenance in addressing Geriatric 4Ms in tele-Palliative Care, (3) number of patients served, (4) travel-miles saved. FY23-24, we conducted 192 AFHS tele-Palliative Care visits, 81% with rural/highly rural Veterans. We served 108 unique patients (FY23:57; FY24:51; percent decrease = 10.5%). Compared to Colorado's Veteran population, Veterans from racial/ethnic minority backgrounds and women were underrepresented; older Veterans were overrepresented. In FY23/FY24, the majority of patients were White (82%/73%), not Hispanic/Latino (83%/73%), male (100%/98%), and ≥65 (90%/89%). All 4Ms were addressed for 86% (FY23) and 76% (FY24) of unique patients. AFHS tele-Palliative Care saved Veterans/caregivers 23 622 (FY23) and 18 632 (FY24) miles of travel. Congruent with AFHS, Palliative Care focuses on physical, emotional, and psychosocial aspects of serious illness. AFHS designation in a tele-Palliative Care clinic is novel nationally. We demonstrated that evidence-based care can be provided to every older adult, regardless of care modality, without expanding staff or changing clinical workflows.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N