The objectives of the current process improvement project were to improve access to health care and enhance care for older adults living in rural areas and to decrease morbidity and mortality. This project implemented an evidence-based screening tool, the Rapid Geriatric Assessment (RGA), as a routine screening in a patient-centered medical home for older adults in rural areas. Z-testing was used to measure the change, defined as scoring positive for at least one of four geriatric syndromes, as a result of using the RGA tool. Approximately one third had at least one such change following implementation of the RGA. In addition to the change in geriatric conditions, a significant change (48%) was noted in the number of patients who implemented an advance directive. We recommend the RGA be integrated in routine screening as it can help providers establish a targeted treatment plan for older adults who may be at increased risk for burden of disease. [Journal of Gerontological Nursing, 48(9), 47–51.]

当前流程改进项目的目标是改善获得医疗保健的机会，加强对农村地区老年人的护理，并降低发病率和死亡率。该项目实施了一种基于证据的筛查工具，即快速老年评估 (RGA)，作为农村地区老年人以患者为中心的医疗之家的常规筛查。Z 检验用于测量变化，定义为使用 RGA 工具对四种老年综合征中的至少一种评分为阳性。大约三分之一的人在实施 RGA 后至少有一次这样的变化。除了老年病的变化外，实施预先指示的患者人数也发生了显着变化（48%）。我们建议将 RGA 纳入常规筛查，因为它可以帮助提供者为可能面临更高疾病负担风险的老年人制定有针对性的治疗计划。[老年护理杂志，48（9），47-51。]