Applying the Age-Friendly Health Systems Framework to Promote Adoption and Sustainability of Interventions for Older Adults in the Intensive Care Unit.

Older adults hospitalized in an intensive care unit (ICU) frequently experience adverse outcomes, including delirium, functional decline, medication-related harm, and goal-discordant care. Despite the availability of evidence-based interventions to address these risks, adoption and sustained implementation remain limited. The Age-Friendly Health Systems 4Ms Framework offers a policy-aligned structure for advancing adoption and sustainability of gerontological nursing interventions in the ICU. The Centers for Medicare & Medicaid Services announcement of the 2025 Age-Friendly Hospital Measure marks a turning point: hospitals will be incentivized to deliver care integrated with the 4Ms (What Matters, Medication, Mentation, and Mobility) to older adults. The introduction of this new measure presents a timely opportunity to align innovative gerontological nursing interventions with institutional quality goals. Grounding interventions in the 4Ms will facilitate engagement with key stakeholders, including frontline health care providers and hospital leadership, who are essential to the adoption and sustainability of age-friendly critical care for older adult patients in the ICU.