How to Meet the New Age-Friendly Medicare Measure

A new Age-Friendly Hospital Measure that includes surgical care for patients 65 and older has been published in the Medicare Hospital Inpatient Quality Reporting Program for 2025.

So, what’s next?

Starting in January, any hospital participating in the Inpatient Quality Reporting Program will risk reimbursement if they can’t demonstrate six quality protocols for surgical and emergency care with older patients.

“Hospitals not participating in this quality reporting program should also take note of what it takes to meet this new measure, because it could become a regulatory requirement,” recommends Kristyn Seeman, MLS, BSN, RN, CNOR. She served as AORN’s liaison on the working group led by the American College of Surgeons to create the measure.

6 Ways to Improve Quality Care for Older Patients

“Ultimately, this measure offers a new tool for interdisciplinary teams to provide equitable, optimized care to older patients who make up 40% of the surgical patient population today,” Seeman explains.

While following this new quality measure could require some changes, perioperative nurses are already positioned to meet this level of quality care for surgical patients aged 65 and older. This is because protocols in the measure align with recommended practices outlined in AORN’s position statement on “Care of the Older Adult in Perioperative Settings” and other evidence-based practices such as medication reconciliation in the AORN Guideline for Medication Safety.

Here Seeman shares nursing-specific tips gleaned from these resources to help perioperative teams meet the new Age-Friendly Hospital Measure and improve care for older patients:

1. Elicit patient health care goals.

“It’s important to recognize that every patient has different health care goals—one patient might be hoping to walk more after a knee replacement, while another might simply be hoping to live long enough to see a grandchild graduate.”

Nursing actions: Communicate with the patient and support person or persons to understand the patient’s specific health goals. Then tailor interventions as an interdisciplinary team to help meet these goals.

2. Responsibly manage medications.

“Every patient’s medications need to be correctly managed when they are planning for a surgical procedure and older patients may have multiple medications from multiple providers. Knowing these medications as well as interactions between them and what is given perioperatively is crucial for a healthy patient outcome.”

Nursing actions: Follow practices for medication reconciliation in recommendations from section 2 of AORN’s Guideline for Medication Safety. Also, be sure to understand and follow the concept of “polypharmacy”— when patients are taking several medications, including those that may be considered high-risk, such as opioid analgesics.

3. Implement frailty screening and intervention (including for cognition and mobility).

“The condition of ‘frailty’ cannot be reversed, so it is imperative that the interdisciplinary surgical team works to ensure that interventions are in place to prevent complications associated with frailty.”

Nursing actions: Implement frailty screening preoperatively as an interdisciplinary team to decrease the chances of mortality and loss of independence. Look to AORN’s forthcoming new guideline on Enhanced Recovery after Surgery (ERAS) protocols to improve frailty screening and subsequent team interventions.

4. Assess social vulnerability such as isolation, caregiver stress, or elder abuse.

“Ensuring that all patients have an equal chance for an optimal surgical outcome is part of a perioperative nurse’s code of ethics. Differences in social aspects of an older patient’s life such as social isolation and elder abuse impact the rate and quality of their recovery.”

Nursing actions: Assess older patients for social vulnerabilities such as food insecurity, lack of reliable transportation, or caregiver stress. This is particularly important for nurses working in pre-op and surgical scheduling to assess and communicate with the surgical team.

5. Designate leaders to ensure the equitable delivery of age-friendly care.

“This Age-Friendly Hospital Measure requires the involvement of nursing staff, and perioperative nurses can be an influential part of meeting the new measure to ensure age-friendly care of surgical patients.”

Nursing actions: Recognize the important role you play in all protocols within this measure because nurses have direct influence in supporting their patients’ surgical outcomes.

Learn more about this new Age-Friendly Hospital Measure.

Use these resources to help your teams meet the measure requirements:

• Geriatric Surgery Verification Program Standards: 2019 Standards from the American College of Surgeons.
• AORN Guideline for Medication Safety in Guidelines for Perioperative Practice.
• Back to Basics: Social Determinants of Health in AORN Journal.
• Perioperative Care of the Older Adult in AORN Journal.