How do clinical nurses implement ‘What Matters to You’ for hospitalized older adults?

Background The Age Friendly Health System (AFHS) 4Ms framework is designed to be clinically implemented to provide reliable, high-quality age-friendly care to older adults with reduced harm and hospital-associated complications. The 4M concept of ‘What Matters to You’ (WMTY) refers to engaging clinicians in assessing and aligning a patient’s specific health outcome goals and care preferences to ensure patient-centered care. There is limited empirical evidence on the WMTY concept and none describing the implementation and impact when used by clinical nurses in hospital settings. Purpose The purpose is to gain an in-depth understanding of the knowledge, perceptions, and experiences of nurses who implement and use the WMTY concept and to evaluate the implementation and impact for older adults. Methods A qualitative, descriptive, phenomenology study will be conducted using focus group discussions to capture key themes and achieve study aims. Research subjects will be recruited from six hospitals who have implemented the AFHS 4 Ms model including implementation leaders and a representative sample of clinical nurses who use the WMTY concept in their daily practice. After informed consent, subjects will complete a demographic survey and participate in a 90 minute virtual focus group using videoconferencing software with recording. Groups will be led by a skilled moderator using a discussion guide based on the 4Ms literature with loose, broad, and open-ended questions. Recordings will be transcribed without identifiers and uploaded into NVivo software. Results Descriptive statistics will be used to identify similarities and differences in participant characteristics across sites. Data will be inductively coded and categorized by two reviewers and iteratively analyzed to identify significant themes. Conclusions/Implications Findings will lay the foundation for designing clinical nurse-targeted interventions to successfully implement WMTY and identifying supportive strategies for partnering with patients and their caregivers to ensure that their goals/preferences are fully integrated into care