Age-Friendly Health Systems Ambulatory Care Continuum


Case Western Reserve University's Frances Payne Bolton School of Nursing, in partnership with CVS MinuteClinic® and with advising from the Institute for Healthcare Improvement (IHI), seeks to extend the impact of the Age-Friendly Health Systems initiative.

This implementation grant aims to integrate the 4Ms Age-Friendly Health Systems Framework in CVS MinuteClinics, the nation’s largest retail ambulatory care network, by means of a strong partnership among the School of Nursing and CVS MinuteClinic and with advising from the Institute for Healthcare Improvement.

Retail clinics have primarily served younger clients who do not have a primary care physician, providing care for routine issues such as vaccinations, physicals, and mild illnesses. However, retail clinics are seeing the age of their clients increase. It's a trend that is expected to continue, and retail clinic health care providers need to be equipped to better serve an aging clientele.

The 4Ms

Research partners at Rush University developed this video on the 4M Framework for an Age-Friendly Health System. The 4Ms were developed through a collaboration of IHI and The John A. Hartford Foundation.

The 4Ms:

  • What Matters
  • Medication
  • Mentation
  • Mobility

Study Design

Through the proposed Ambulatory Care Extension planning effort, the vision is to develop a plan to implement the Age-Friendly Health Systems initiative within the CVS MinuteClinic health system. One-year planning goals will include the following:

We will use implementation strategies to assist MinuteClinics' success in becoming Committed to Care Excellence in the IHI’s Age-Friendly Health System Action Community, while also evaluating the effectiveness of implementation strategies.

Produce and test a professional development learning platform that includes training modules and practice-based tools to facilitate assessment and action steps for the implementation of the 4Ms (What Matters, Medications, Mentation, and Mobility) based on Age-Friendly Health System content;

Assess the existing age-friendly evaluation metrics of the Age-Friendly Health Systems initiative and the needs of the CVS MinuteClinic in order to develop a process through which to embed age-friendly process and outcome measures into the CVS MinuteClinic electronic health record platform, Epic.

Research Team

The project team will function as a collaborative partnership across the School of Nursing and CVS MinuteClinic as a means to extend the reach and impact of Age-Friendly Health Systems principles within ambulatory care settings. IHI will serve as advisors to the project team.  As a result of this planning effort, the project team will be poised to pilot and spread the implementation of the Age-Friendly Health Systems initiative within CVS MinuteClinics through a Phase II implementation beginning in select regions with greater concentrations of older adults, and ultimately scaling to all 1,100 CVS MinuteClinic locations across the nation.

CWRU Researchers

Mary Dolansky, PhD, RN, FAAN, Principal Investigator

Ronald Hickman, PhD, RN, ACNP-BC, FAAN, Implementation Team Lead

Evelyn Duffy, DNP, AGPCNP, FAAN, Professional Development Lead

Nicholas Schlitz, PhD, Evaluation Team Lead

Brian Crick, Technology Development Team Lead

Robin Y. Hughes, AGCNP, Project Manager


Collection of logos for the Age-Friendly Health Systems Ambulatory Care Continuum Study. CVS, IHI, CWRU, and John A. Hartford Foundation.