Applications open September 25 for the next round of grants
BOSTON, September 23, 2024 – The Institute for Healthcare Improvement (IHI) has awarded grants to seven health care systems to test new and novel ways to improve the care and outcomes of older adults through the reliable implementation of best practices and innovations supporting age-friendly diagnostic practices. The Diagnostic Excellence – Age-Friendly Health Systems (DxEx – AFHS) Seed Grant Program is supported by the Gordon and Betty Moore Foundation and The John A. Hartford Foundation.
The seven grantees will test new interventions and practices using improvement and/or implementation science to improve diagnosis for older adults (65+ years), aligned with the 4Ms of Age-Friendly Health Systems (What Matters, Medications, Mentation, and Mobility).
“The diagnostic projects that these grants are funding will improve the care and lives of older adults. Congratulations to the grantees of Cohort 1, and welcome to the IHI Learning Network,” said Jeffrey Salvon-Harman, MD, CPPS, IHI Vice President, Safety. “We encourage researchers with quality improvement experience, particularly from resource-challenged organizations or care settings, to apply for Cohort 2 of the Diagnostic Excellence - Age Friendly Health Systems Seed Grant Program. Together we can innovate improvements in diagnostic excellence for older adults contextualized by age-friendly care."
Grantees were selected for their ability to support non-geriatricians in various settings, foster meaningful engagement of older adult patients and families, and improve equity and mitigate disparities including ageism, race/ethnicity, gender, and/or social determinants of health.
Building on the previously successful Society to Improve Diagnosis in Medicine Diagnostic (SIDM) Quality Improvement Seed Grant Program, IHI is engaging the grantees in a Learning Network. During the 21-month grant period, the network will facilitate learning among the grantees and support integration of quality improvement in all projects.
On September 25, IHI will begin accepting applications for the next Cohort of the Seed Grant Program. IHI, with the support of The John A. Hartford Foundation, will award up to eight grants of up to $75,000 each to health care organizations to pilot-test new interventions and practices to improve diagnosis for older adults. For eligibility, program funding, and information about how to apply, review the Request for Proposals for Cohort 2.
About the grant recipients (Cohort 1) and their projects:
- Banner Health: In pilot research, Banner Health has identified key variables routinely recorded by nursing staff during patient care that can improve the detection of delirium. This project involves implementing a Clinical Decision Support tool designed to integrate into existing electronic medical record (EMR) systems. The tool functions as an early warning system for delirium detection, similar to the SAFE alert for sepsis. It aims to enhance the early detection and management of delirium, ultimately improving patient outcomes in older adults.
- Baylor College of Medicine – Harris Health System: Alzheimer’s Disease and Related Dementias (ADRD) is a leading cause of disability among older adults. This project will focus on an educational intervention featuring an easy-to-use guide to help identify early warning signs of ADRD. The educational guide will be co-created with patients, caregivers, and local community stakeholders to ensure culturally relevant messaging and effective information sharing strategies. By applying diverse methodologies, including quality improvement strategies and visual research methods, the project aims to improve timely diagnosis among older Black women and respond to this critical call to action.
- Brigham and Women’s Hospital: This project will focus on proactive surveillance, which has the potential to identify adverse drugs reactions (ADRs) earlier and diagnose drug-induced illnesses that would have otherwise been overlooked or misdiagnosed. Leveraging automated electronic tools can powerfully enhance the scope and scale of such efforts. Coupling automated surveillance with pharmacists experienced in ADR evaluation further adds diagnostic safety to help diagnose patients’ symptoms, while taking work off busy physicians’ plates.
- Native Healthcare Center: This project aims to reduce health disparities among Native American elders in Houston using the 4Ms framework: addressing what matters by honoring cultural values, managing medications safely with traditional and western approaches, improving mentation by reducing mental health stigma, and supporting mobility to overcome physical barriers. The goal is to build trust, enhance access, and improve health outcomes within the community.
- MedStar Health: Caregivers help maintain the health and care needs of older adults, and they are critical historians and messengers when it comes to reporting patterns of older adults’ day-to-day lives and recognizing any acute changes in cognitive and behavioral symptoms. This project aims to formally incorporate caregivers into the diagnostic process, building on existing patient-facing diagnostic communication tools. By equipping caregivers with tools to share critical information and evaluating its implementation in a primary care practice, the project seeks to reduce diagnostic errors and improve timely diagnoses of dementia in older adults.
- Michael E. DeBakey VA Medical Center: Acute kidney injury (AKI) is a serious complication that occurs in patients with cirrhosis. Community-acquired AKI (CA-AKI), AKI that develops outside of the hospital, is the most common form of AKI globally. AKI development is more common in elderly patients, who are prone to underdiagnosis and undertreatment for AKI. These missed opportunities for AKI diagnosis could lead to significant harm, such as prolonged hospitalizations and death. The goal of this project is to reduce missed diagnosis of CA-AKI and enhance CA-AKI resolution rates in elderly patients with cirrhosis. By identifying and addressing missed diagnosis for CA-AKI and implementing early AKI care strategies, outcomes could be improved in elderly patients with cirrhosis.
- Veterans Affairs Maryland Healthcare System: Diagnosis of urinary tract infections (UTIs) in older adults is extremely challenging; urine cultures are often falsely positive, and symptoms are non-specific. This leads to many diagnostic safety events, including both wrong diagnosis and missed/delayed diagnosis, as well as adverse events from excessive unnecessary antimicrobial exposure. Among older adults, the diagnostic process for UTIs is often disjointed, further contributing to diagnostic safety issues. This project aims to implement a UTI diagnosis and management intervention that will holistically incorporate the 4Ms of age-friendly care to improve clinician workflow and patient outcomes for veterans receiving care within Community Living Centers of the VA Maryland Healthcare System (VAMHCS).
About the Institute for Healthcare Improvement (IHI)
The Institute for Healthcare Improvement (IHI) is a leading, globally recognized not-for-profit health care improvement organization that has been applying evidence-based quality improvement methods to meet current and future health care challenges for more than 30 years. IHI provides millions of people in health care with methods, tools, and resources to make care better, safer, and more equitable; convenes experts to enable knowledge sharing and peer-learning; and advises health systems and hospitals of all sizes in improving their systems and outcomes at scale. IHI’s mission is to innovate and lead transformational improvement in health and health care worldwide.
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