PMID: 9547681Apr 21, 1998Paper

Improving functional outcomes in older patients: lessons from an acute care for elders unit

The Joint Commission Journal on Quality Improvement
K E CovinskyC S Landefeld

Abstract

Hospitalization often marks the beginning, and may be partially responsible for, a downward trajectory characterized by declining function, worsening quality of life, placement in a long term care facility, and death. At the University Hospitals of Cleveland, an Acute Care for Elders (ACE) unit that reengineered the process of caring for older patients (> or = 70 years of age) to improve functional outcomes was established in September 1990. The general principles of ACE included an approach to care guided by the biopsychosocial model and recognition of the importance of fitting the hospital environment to the patient's needs. The design of the intervention was consistent with principles of comprehensive geriatric assessment and continuous quality improvement. Care, which focused on maintaining function, was directed by an interdisciplinary team that considered the patient's needs both at home and in the hospital. The major components of the ACE Unit intervention included patient-centered nursing care (daily assessment of functional needs by nursing, nursing-based protocols to improve outcomes, daily rounds by a multidisciplinary team), a prepared environment, planning for discharge, and medical care review. In a randomized tri...Continue Reading

References

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Citations

Aug 6, 2004·Journal for Nurses in Staff Development : JNSD : Official Journal of the National Nursing Staff Development Organization·Tina Weitzel, Sherry B Robinson
Dec 4, 2003·Journal of Advanced Nursing·Karen HancockYun-Hee Jeon
May 23, 2007·Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses·Luis F AmadorCheryl A Lehman
Nov 21, 2007·International Journal of Clinical Practice·S J HannaS Kesavan
Jun 20, 2008·Journal of Gerontological Nursing·Sherry Dahlke, Alison Phinney
Mar 20, 2010·The Cochrane Database of Systematic Reviews·Thomas RotterJoachim Kugler
May 20, 2015·Journal of General Internal Medicine·Anna H ChodosEdgar Pierluissi
Feb 3, 2015·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Arif NazirMalaz Boustani
Jun 10, 2003·Journal for Nurses in Staff Development : JNSD : Official Journal of the National Nursing Staff Development Organization·Sherry B Robinson, Tina Weitzel
Dec 14, 2012·The Cochrane Database of Systematic Reviews·Francesca DwamenaAdesuwa Olomu
Dec 18, 2013·Journal of Interprofessional Care·Souraya Sidani, Mary Fox
Sep 13, 2017·The Cochrane Database of Systematic Reviews·Graham EllisSasha Shepperd
Sep 14, 2019·Canadian Journal on Aging = La Revue Canadienne Du Vieillissement·Sherry DahlkeAdrian Wagg
Oct 8, 2003·Journal of Gerontological Nursing·Esther ChangKaren Hancock
Dec 31, 2004·Holistic Nursing Practice·Tina WeitzelKathy Anderson
Mar 16, 2012·The Cochrane Database of Systematic Reviews·Amy DrahotaTaraneh P Dean
Feb 14, 2009·Social Work in Public Health·L Gail Dobell, Robert J Newcomer
Mar 19, 2004·Journal of Clinical Nursing·Brendan McCormack
Nov 28, 2012·Journal of the American Geriatrics Society·Mary T FoxEllen Schraa
Oct 4, 2002·Biological Psychiatry·George S AlexopoulosK Ranga R Krishnan

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