Age-friendly health care and the 4Ms in RN-led annual wellness visits

BACKGROUND

Medicare annual wellness visits (AWVs) are prevention-focused healthcare visits free to Medicare recipients. These visits focus on health maintenance, health risk assessment, prevention of illness, and maintaining independence, all of which are within the scope of registered nurse (RN) practice as well as aligned with what matters, medication, mentation, and mobility - the 4Ms - of age-friendly health care. The objective of this pilot study was to evaluate the implementation of the 4Ms in the context of RN-led Medicare AWVs in a primary care practice.

METHODS

In a primary care practice with approximately 2500 patients, including approximately 571 of whom were enrolled in Medicare, RN-led Medicare AWVs were implemented, incorporating the 4Ms framework. During this time, data were collected on the effect of the AWV on access to care-conceptualized here as the number of visits available as well as the type of clinician open to staff these visits. Data collection also included patient responses to the 4Ms question "what matters most?"

RESULTS

Overall, the RN-led visits were successful and beneficial to the practice. Each RN-led visit allowed for 2 additional acute or monitoring visits per provider (nurse practitioner, MD) per day, increasing patient access to their primary care providers. Inclusion of the 4Ms questions facilitated discussion around overall mental and emotional well-being, life stressors, quality of life, and goals of care.

CONCLUSION

RN-led Medicare AWVs incorporating the 4Ms framework enhances the role of RNs in primary care by focusing on a health promotion role, utilizing RNs to their full scope of practice. RN-led AWVs increase provider availability for acute and chronic care appointments, as well as foster conversations around quality of life, as well as mental and emotional well-being.

AGING IS VERY PERSONAL: INTERPROFESSIONAL GERONTOLOGY COURSE IMPROVING STUDENT ATTITUDES TOWARD OLDER ADULTS

Educational programs that foster the development of a robust healthcare workforce committed to the provision of exemplary care of older adults is vital. The Aging is Very Personal (AIVP) service learning gerontology course has demonstrated the ability to foster future student interest and improved attitudes towards working with older adults. The AIVP program provides mutual benefit for undergraduate students from a variety of health science majors and older adult resident volunteers at local senior living facilities. For students, AIVP serves as direct insight into the lived experience of aging among community older adults. Students are provided the opportunity to practice communication skills, relationship-building skills, and gain an understanding of the multitude of diverse needs within this population. Older adults who volunteer to participate in the activity are provided with the opportunity to speak to and actively engage with students and feel empowered by the opportunity to provide valuable life guidance. This presentation will provide a curricular overview of the steps required to construct, implement, and evaluate an interprofessional gerontology course. A review of student learning objectives, service-learning program construction, selected course topics, and student assignments will be presented. Attitudes and future interest in working with older adults measured in the initial interprofessional student cohort (n=106) will be presented. A pre-established, validated tool utilized to effectively measure student attitudes and interest pre/post-course participation will be reviewed.