Establishing and sustaining an acute care for elders unit: An incremental journey to success
Acute Care for Elders (ACE) units reduce hospital‐associated delirium, functional decline, and lengths of stay. However, establishing and sustaining such units have proven difficult. There are only 43 ACE units among the >3500 hospitals in the United States. This study describes an iterative qual...
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| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2023-10, Vol.71 (10), p.3031-3039 |
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| container_title | Journal of the American Geriatrics Society (JAGS) |
| container_volume | 71 |
| creator | Lynch, David H. Mournighan, Kimberly Dale, Maureen Spangler, Hillary B. Gotelli, John Davis, Ronald Felton, Kittra Lingley‐Brown, Kara Busby‐Whitehead, Jan Batsis, John A. Hanson, Laura C. |
| description | Acute Care for Elders (ACE) units reduce hospital‐associated delirium, functional decline, and lengths of stay. However, establishing and sustaining such units have proven difficult. There are only 43 ACE units among the >3500 hospitals in the United States. This study describes an iterative quality improvement process, which allowed us to establish and sustain an ACE unit care model in a modern academic hospital. This continuous process was centered on implementing the key principles of the ACE unit model of care: patient‐centered care assessments, medical care review, specialized prepared environment, early mobilization, physical therapy, and early planning for discharge to home. Quality of care and patient outcomes data for older adults admitted to our ACE unit includes mortality index (observed/expected) consistently |
| doi_str_mv | 10.1111/jgs.18561 |
| format | Article |
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However, establishing and sustaining such units have proven difficult. There are only 43 ACE units among the >3500 hospitals in the United States. This study describes an iterative quality improvement process, which allowed us to establish and sustain an ACE unit care model in a modern academic hospital. This continuous process was centered on implementing the key principles of the ACE unit model of care: patient‐centered care assessments, medical care review, specialized prepared environment, early mobilization, physical therapy, and early planning for discharge to home. Quality of care and patient outcomes data for older adults admitted to our ACE unit includes mortality index (observed/expected) consistently <1 (FY22 = 0.86), 30‐day readmission rate of <10% (FY22 9.31%), and length of stay index of ~1 (FY22 1.07). We describe how work on our ACE unit has led to hospital‐wide initiatives, including dementia‐friendly hospital certification. Our hope is that others can use this process to enhance the dissemination of the ACE unit model of care.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.18561</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc</publisher><subject>Dementia disorders ; Discharge planning ; Elder care ; Geriatrics ; Inpatient care ; Older people ; Patient care planning ; Patient-centered care ; Patients ; Physical therapy ; Quality control ; Rehabilitation</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2023-10, Vol.71 (10), p.3031-3039</ispartof><rights>2023 American Geriatrics Society and Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c250t-4af7b18e5ba9ce1ce25cde3b2aeb92e2a41729a5385da643112c41566ae8894d3</cites><orcidid>0000-0003-4027-4113 ; 0000-0002-0845-4416 ; 0000-0002-2512-9367</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Lynch, David H.</creatorcontrib><creatorcontrib>Mournighan, Kimberly</creatorcontrib><creatorcontrib>Dale, Maureen</creatorcontrib><creatorcontrib>Spangler, Hillary B.</creatorcontrib><creatorcontrib>Gotelli, John</creatorcontrib><creatorcontrib>Davis, Ronald</creatorcontrib><creatorcontrib>Felton, Kittra</creatorcontrib><creatorcontrib>Lingley‐Brown, Kara</creatorcontrib><creatorcontrib>Busby‐Whitehead, Jan</creatorcontrib><creatorcontrib>Batsis, John A.</creatorcontrib><creatorcontrib>Hanson, Laura C.</creatorcontrib><title>Establishing and sustaining an acute care for elders unit: An incremental journey to success</title><title>Journal of the American Geriatrics Society (JAGS)</title><description>Acute Care for Elders (ACE) units reduce hospital‐associated delirium, functional decline, and lengths of stay. However, establishing and sustaining such units have proven difficult. There are only 43 ACE units among the >3500 hospitals in the United States. This study describes an iterative quality improvement process, which allowed us to establish and sustain an ACE unit care model in a modern academic hospital. This continuous process was centered on implementing the key principles of the ACE unit model of care: patient‐centered care assessments, medical care review, specialized prepared environment, early mobilization, physical therapy, and early planning for discharge to home. Quality of care and patient outcomes data for older adults admitted to our ACE unit includes mortality index (observed/expected) consistently <1 (FY22 = 0.86), 30‐day readmission rate of <10% (FY22 9.31%), and length of stay index of ~1 (FY22 1.07). We describe how work on our ACE unit has led to hospital‐wide initiatives, including dementia‐friendly hospital certification. 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| ispartof | Journal of the American Geriatrics Society (JAGS), 2023-10, Vol.71 (10), p.3031-3039 |
| issn | 0002-8614 1532-5415 |
| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Dementia disorders Discharge planning Elder care Geriatrics Inpatient care Older people Patient care planning Patient-centered care Patients Physical therapy Quality control Rehabilitation |
| title | Establishing and sustaining an acute care for elders unit: An incremental journey to success |
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