There are 77 million baby boomers in the U.S; 10,000 turn 65 each day. By 2030, the number of Americans age 65 and older is expected to reach 70 million or 20% of the population. While those 65 years of age and older currently comprise only ~13%-14% of the US population, they have much higher rates of healthcare utilization including hospitalizations than other age groups – adults ≥65 yo comprise ~40% of the Medical Center discharges.
In 2010, only ~40% of adult hospitalizations were for ≥65 yo
By 2030, only ~40% of adult hospitalizations will be for <65 yo
Older adults have higher rates of chronic conditions, hospital-acquired harm events, and readmissions <30 days than other age groups. As the older adult population grows, there will be a significant increase in the demand for health services that meet their unique needs. The projected number of older hospitalized patients makes it impractical to segregate all older adults on specific units – such as an ACE Unit. This implies systematically instilling such principles at every level to ensure the older adult patient receives high-quality, patient-centered care throughout their Medical Center experience, regardless of unit or location.
UCSF Gerontological Nursing Vision Statement: To enhance and sustain the capacity and competency of nursing staff in providing quality, equitable patient-centered care to older adult patients and their families, as well as implementing system-wide improvements in the care of older adults.
To achieve the misison of providing the best quality, equitable and patient-centered care to our older adults, the UCSF Nursing Department has adopted the nationally recognized standards of the Age-Friendly Health System and NICHE care delivery models/frameworks.
UCSF Age-Friendly Health System
UCSF has been recognized as an Age-Friendly Health System – Committed to Care Excellence site which is the highest level awarded for exemplars in the movement. The UCSF Nursing Department is committed to practicing within an Age-Friendly Health System (AFHS) framework, one that focuses on the special needs of all older adults. The AFHS movement is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) in partnership with the American Hospital Association (AHA) among others. To learn more about this movement, click here.
In addition, we are working with our Division of Geriatrics and health system leaders to ensure that all older adults at UCSF receive Age-Friendly care guided by the 4Ms:
NICHE
Established in 1992 out of the NYU College of Nursing, NICHE (Nurses Improving Care for Healthsystem Elders) is an initiative of the Hartford Institute for Geriatric Nursing. NICHE is the leading national, nurse-driven program designed to foster system-wide improvement in the care of older patients in healthcare organizations through comprehensive nursing education and consultation.
Key strategies of NICHE and its member sites include:
- Increase the geriatric competence of nursing staff
- Create evidence-based, age sensitive care delivery systems
- Create a nursing age-friendly environment
UCSF is a proud NICHE designated hospital. NICHE designation demonstrates a hospital’s organizational commitment and continued progress in improving quality, enhancing the patient and family experience, and supporting the hospital and other healthcare organization’s efforts to serve its communities. UCSF has adopted the NICHE Geriatric Resource Nurse (GRN) model of care in alignment with the UCSF True North Pillars with the goal of achieving systematic nursing change that will benefit hospitalized older adult patients and reduce adverse health outcomes in this patient population:
- Improve nursing staff knowledge, attitudes, and perceptions around best practices for the care of older adults.
- Disseminate evidence-based nursing practice and increase engagement and professional growth among staff nursing participants.
- Foster quality improvement efforts focused on the unique needs of our older adult patients.
- Reduce harm events in older adult inpatients.
NICHE membership provides access to free geriatric nursing resources, including RN and PCA education. For access to these resources, please click here to submit a request.
Quick Links:
- Nurses Improving Care for Healthsystem Elders (NICHE)
- The Hartford Institute for Geriatric Nursing (HIGN)
- HIGN Geriatric Nursing Protocols and Symptoms
- HIGN Try This® Series: Best Practices in Nursing Care for Older Adults
- ANCC Gerontological Nursing Certification
For questions or more information, contact your NICHE Knowledge Center Administrator:
Charlie Dharmasukrit, PhD, RN, NPD-BC, CMSRN
Nursing Professional Development Specialist-Adult Acute/Transitional Care