Date of Doctor of Nursing Practice Project Completion
Fall 2026
Faculty Advisor
Dr. Madelene Ottosen
Abstract
Purpose
To improve adherence in assessing and documenting “What Matters” (WM) using a standardized assessment and documentation process.
Background
The project was implemented within a large Age-Friendly Health System (AFHS) in Houston, Texas, comprised of a geriatric outpatient clinic and a House Call program. Although the 4Ms of AFHS were regularly documented in the outpatient setting, there was limited documentation in the House Call Program.
Methodology
A standardized process was established with clinician stakeholders to assess and document WM using simplified assessment criteria, the electronic medical record (EMR) 4Ms documentation phrase, and a designated location for the 4Ms phrase in the EMR. Retrospective chart review data were compared to post- intervention data through biweekly chart reviews. The baseline period was 6 months, and 21 charts were reviewed, while the 3-month implementation period reviewed 92 charts. Three PDSA cycles were implemented based on stakeholders’ input and chart audit results, including changes to the chart audit tool.
Results
The adherence rate improved from an average baseline of 35% to 69% during the monthly implementation period. Additionally, there was a notable increase in family/caregiver involvement from 6% at baseline to 39% at the end of implementation.
Implications
Having standardized language and clarity among providers regarding where and how to assess all 4Ms components is essential. The success of this project depends on a consistent reminder prompt, an AFHS 4M’s template integrated into the EMR, and a sustainable strategy to increase family and caregiver involvement in WM assessment.
Key words: age-friendly health system, what matters most, geriatrics, house calls program, 4Ms, documentation
Keywords
age-friendly health system, what matter, geriatrics, house call program, 4Ms, documentation
Recommended Citation
Thelma I. Arzu, "Improving Assessment and Documentation Adherence in an Age-Friendly Health System with a focus on "What Matters"" (2026). Doctor of Nursing Practice Final Project Abstract. 182.
https://digitalcommons.library.tmc.edu/dnp_abstract/182