The U.S. healthcare system is facing a defining challenge: Older adults are the fastest-growing patient population, yet our hospital care models have not kept pace.
Through the West Health Accelerator at Mass General Brigham — a collaboration between Somerville, Mass.-based Mass General Brigham and the West Health Institute — we are taking on the challenge to deliver better inpatient care for older adults. We are redesigning care delivery in ways that are both clinically meaningful and operationally feasible while making it easier for clinicians to deliver the best care.
Based on this collaboration, we have identified three practical strategies to help hospitals move forward now:
1. Focus on high-impact basics. Some of the most effective interventions for older adults are also the simplest, but they are not reliably delivered. Preventing delirium and functional decline often comes down to consistently getting the basics right, every time. That means making sure patients get out of bed, sleep at night, receive the right medications at the right doses, and have consistent oral care and appropriate bowel regimens.
These interventions are best practices. They are neither new nor complex, but they do require systems that support consistent execution. Focusing on these fundamentals is one of the fastest ways to improve outcomes for older adults, without adding new layers of work.
2. Embed best practices into routine care. We truly believe that everybody who provides patient care wants to do the right thing. The problem is not in the motivation, but in the design. If we want to improve outcomes, we have to make it easier to do the right thing. Our efforts to improve care must support clinicians, not add complexity.
One of our biggest learnings so far has been to include frontline staff from the beginning and meet them where they are. That starts with listening to clinicians — understanding their workflows, their constraints, and where care breaks down. From there, the work is about integrating those high-impact basics into your hospital’s existing workflows rather than introducing separate checklists or additional tasks.
3. Build alignment and communicate with purpose. Creating consistency in messaging, clarity in goals, and alignment with organizational priorities is critical to gaining and sustaining momentum. Everyone involved in patient care, from frontline clinicians to executive leadership, needs to understand not only what is changing but also how it supports their work. When that alignment is clear, this work resonates across the organization.
It is also crucial to be intentional and consistent about how change is introduced. Approaches framed as “one more thing to do” rarely succeed. But when teams see that these changes make their work easier, more efficient, and more aligned with the care they want to provide, they are usually quick to adopt these practices.
In a time of competing pressures, improving care for older adults offers a rare opportunity to align patient-centered care with operational realities — and to do both better. At its core, the West Health Accelerator at Mass General Brigham is about something bigger: the origin seed of a movement to urgently transform care for older adults in our hospitals.
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