Quality improvement for age-friendly care: an experiential model for instructing medical students in system-based practice

Early learning experiences in quality improvement (QI) can prepare medical students for practice in complex health systems and can improve processes of care for various groups, including older adult patients with multiple chronic conditions. We applied the Institute for Healthcare Improvement (IHI) Age-Friendly Health Systems 4Ms framework to a twelve-week geriatrics-focused QI project for third-year medical students training in rural medicine. Students (N = 40) conducted their projects at primary care practice sites and focused on the identified needs of older adult patients within the 4Ms framework areas of Mobility, Mentation, Medication, and What Matters. Students completed evaluation surveys to rate the usefulness of training and to self-assess knowledge and skills using five-point Likert-type items. Students (n = 23) reported increased knowledge and skills in conducting QI activities and improved understanding of the importance of improving processes and patient care. Such projects for QI training can support competency development in systems-based practice while also implementing practice frameworks for improving processes and patient care, such as the use of Age-Friendly practices and resources within a health care setting.