Acute Care for Elders (ACE)

Clinical significance

• greater independence in ADLs at discharge
• less frequent discharge to a nursing home
• somewhat shorter & less expensive hospitalization
• improved patient satisfaction & family satisfaction
• reduced costs of care
• fewer falls
• less delirium

Procedure

• environment to promote mobility & orientation
  • carpeting
  • raised toilet seats
  • low beds
  • clocks
  • calendars
  • pictures to promote orientation
• interdisciplinary, team-based, patient-centered care
  • nursing-initiated protocols for independent self-care, nutrition, sleep hygiene, skin care, mood & cognition
• early discharge planning
  • social work involvement to mobilize family & other resources at home
• medication reconciliation

Notes

• outcomes dependent upon function of interdisciplinary team
• no effect on mortality
• no effect on pressure ulcer rates
• controversy over effect on hospital readmissions

More general terms

• management