ArticleImplementation science communications2023
Study protocol: Type III hybrid effectiveness-implementation study implementing Age-Friendly evidence-based practices in the VA to improve outcomes in older adults.
Article in Implementation science communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Strategies and Outcomes of Age-Friendly Health System Implementation in Outpatient Settings: A Systematic Review.Inquiry : a journal of medical care organization, provision and financingPooled it
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- Reliability of a rating rubric to assess quality of preoperative goals of care notes.American journal of surgery · 2026Article
- Real-world quantification of implementation dose across twenty-five implementation instances.Implementation science communications · 2025Article
- Incorporating Implementation Science Into Frailty Interventions for Cardiovascular Disease.JACC. Advances · 2025Review
- Beyond Accuracy: Methodological Advances for Assessing the Clinical Impact of Infectious Disease Diagnostics.Open forum infectious diseases · 2025Article
- On the same (evaluation) page: a novel approach to enhance mixed-methods implementation evaluation.BMJ open quality · 2025Article
- The Surgical Pause: The Importance of Measuring Frailty and Taking Action to Address Identified Frailty.Joint Commission journal on quality and patient safety · 2025Article
- Hospital 4Ms: Documentation and association with patient characteristics.Journal of the American Geriatrics Society · 2025Article
- "What Matters" in the Emergency Department: A Prospective Analysis of Older Adults' Concerns and Desired Outcomes.Medical care · 2024Observational
- Implementation of the Age-Friendly Health Systems Initiative in the Department of Veterans Affairs: 5 Years of Improving Quality for Older Veterans.Inquiry : a journal of medical care organization, provision and financingArticle
- Challenges and Opportunities in Implementing a Multicomponent Dementia Caregiver Program in a Complex Healthcare System.Inquiry : a journal of medical care organization, provision and financingArticle
- Age Friendly Health Systems: Pivoting from Breadth to Depth.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundUnmet care needs among older adults accelerate cognitive and functional decline and increase medical harms, leading to poorer quality of life, more frequent hospitalizations, and premature nursing home admission. The Department of Veterans Affairs (VA) is invested in becoming an "Age-Friendly Health System" to better address four tenets associated with reduced harm and improved outcomes among the 4 million Veterans aged 65 and over receiving VA care. These four tenets focus on "4Ms" that are fundamental to the care of older adults, including (1) what Matters (ensuring that care is consistent with each person's goals and preferences); (2) Medications (only using necessary medications and ensuring that they do not interfere with what matters, mobility, or mentation); (3) Mentation (preventing, identifying, treating, and managing dementia, depression, and delirium); and (4) Mobility (promoting safe movement to maintain function and independence). The Safer Aging through Geriatrics-Informed Evidence-Based Practices (SAGE) Quality Enhancement Research Initiative (QUERI) seeks to implement four evidence-based practices (EBPs) that have shown efficacy in addressing these core tenets of an "Age-Friendly Health System," leading to reduced harm and improved outcomes in older adults.
methodsWe will implement four EBPs in 9 VA medical centers and associated outpatient clinics using a type III hybrid effectiveness-implementation stepped-wedge trial design. We selected four EBPs that align with Age-Friendly Health System principles: Surgical Pause, EMPOWER (Eliminating Medications Through Patient Ownership of End Results), TAP (Tailored Activities Program), and CAPABLE (Community Aging in Place - Advancing Better Living for Elders). Guided by the Pragmatic Robust Implementation and Sustainability Model (PRISM), we are comparing implementation as usual vs. active facilitation. Reach is our primary implementation outcome, while "facility-free days" is our primary effectiveness outcome across evidence-based practice interventions. DISCUSSION: To our knowledge, this is the first large-scale randomized effort to implement "Age-Friendly" aligned evidence-based practices. Understanding the barriers and facilitators to implementing these evidence-based practices is essential to successfully help shift current healthcare systems to become Age-Friendly. Effective implementation of this project will improve the care and outcomes of older Veterans and help them age safely within their communities.
trial registrationRegistered 05 May 2021, at ISRCTN #60,657,985. REPORTING GUIDELINES: Standards for Reporting Implementation Studies (see attached).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.