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.

Accessing Age-Friendly Health Education Tools

We have created a website for the project that describes our project and showcases our educational products. You can access the portal below.

Visit the Age-Friendly Health Systems Portal

The 4Ms

  • What Matters
  • Medication
  • Mentation
  • Mobility

Project Highlights

Through the proposed Ambulatory Care Extension effort, we have developed educational and practice-based tools as well as age-specific, patient-friendly resources during the implementation the Age-Friendly Health Systems initiative within the CVS MinuteClinic health system.

Understanding 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. 

Patient Care using the 4Ms

This video shows how to integrate the 4Ms assessment into a routine clinical visit with a patient 65 years old or older. 

We are currently implementing multiple strategies to assist MinuteClinics' success in becoming Committed to Care Excellence through the Institute for Healthcare Improvement while also evaluating the effectiveness of implementation strategies. The Committed to Care Excellence is a recognition for being an exemplar in the movement based on 4Ms work that is aligned with the Age-Friendly Health System Guide to Using the 4Ms in the Care of Older Adults AND at least three months’ count of older adults reached with evidence-based, 4Ms care.

Implementing a 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 functions 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 serves as advisors to the project team. The project team is currently implementing the Age-Friendly Health Systems initiative within CVS MinuteClinics through its Phase II, ultimately scaling to all 1,200 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, MSN, AGCNP, Project Manager


Logo for the John A. Hartford Foundation
Logo for CVS Minute Clinic
Age-Friendly Health Systems Logo
Logo for the Institute for Healthcare Improvement