acute care for elderly ace (we certainly think we are)
DESCRIPTION
Acute Care for Elderly ACE (We certainly think we are). Aim. Aim : To improve the care for over 85 year old acute geriatric patients by implementing an Acute Care for the Elderly model, as evidenced by – Decrease in Acute-Rehab LOS from 25 - 20 Days Decrease in ACE LOS from 8.5 - 7 Days - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/1.jpg)
Acute Care for Elderly
ACE(We certainly think we are)
![Page 2: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/2.jpg)
Aim
Aim: To improve the care for over 85 year old acute geriatric patients by implementing an Acute Care for the Elderly model, as evidenced by –
• Decrease in Acute-Rehab LOS from 25 - 20 Days• Decrease in ACE LOS from 8.5 - 7 Days• Decrease in readmission rate from 6% - 4%• Decrease in step down of care rate from 14% - 8%
![Page 3: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/3.jpg)
Overview of ACE
• What – Geriatrician led, comprehensive MDT care for acute elderly focusing on a sustainable return home
• Who – >85yo, acute admission, excludes specialist conditions, frail, complex needs
• How – Intensive MDT model, early screening, early and preventative rehab, comprehensive geriatric assessment, removal of a transition of care for those requiring rehab
• Why – Vulnerable patient group, higher readmissions, high rate of step down in care, unmet need
![Page 4: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/4.jpg)
Challenges/Learnings
• Defining an “ACE” patient
Refining our acceptance criteria
• Getting ACE patients to the ward
Education
Operational shift
Culture change
• Understanding what we had changed and if our baseline was still relevant
![Page 5: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/5.jpg)
Review of Baseline
50 patients per month
90 patients per month
150 patients per month
300 patients per month
![Page 6: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/6.jpg)
Successes
• JaM tool – Quick identification of patients at risk of step down in care
Aim to get high value patients
• Admission screen
Facilitates combined MDT approach leading to combined care planning
• 9am Huddle
Improves regular ward communication and a team based approach
![Page 7: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/7.jpg)
Summary Data to Date
Baseline Target 5 Month Average
7 day Re-admission rate
6% 4% 2.6%
Rate of step down of care
14% 8% 8.8%
Acute ALOS 7 days 7 days 8.5 days
Combined ALOS – ACE/AT&R
24.9 days 20 days 15.9 days
![Page 8: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/8.jpg)
Acute to Rehab Journey >85’s
![Page 9: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/9.jpg)
Acute to Rehab Journey >85’s
Baseline
24.9 days
Post ACE
16.9 days
![Page 10: Acute Care for Elderly ACE (We certainly think we are)](https://reader036.vdocuments.net/reader036/viewer/2022062408/56813ada550346895da31e8c/html5/thumbnails/10.jpg)
• Mrs W – Chest infection, delirium, dementia, pressure area, reduced mobility
• Screening showed cognition declined, variable mobility, poor food intake
• Cared for by daughter – burn out, not engaged and didn’t have the skills
• Meeting with daughter/CN/SW
• Day care and respite arranged
• Daughter educated re pressure care,
feeding and spent time with
PT/Nursing to learn cares
• D/C home
Case Study