Acute Care for Elders (ACE) Program at OHSU Hospital

Oregon Health & Science University (OHSU)

Status: Unknown

Conditions: Drug-Related Side Effects and Adverse Reactions; Hospital Acquired Pressure Ulcer; Delirium; Age-Related Cognitive Decline; Frail Elderly

Treatments: Other: Acute Care of Elders focused geriatric care

Study type: Interventional

Funder types: Other

Identifiers

NCT02119078

RB00010420

Details and patient eligibility

About

The purpose of this investigation is to assess the effectiveness of a multi-disciplinary Acute Care for Elders (ACE) program dedicated to the care of patients age 70 and older admitted to Oregon Health & Science University's hospital medicine service. The ACE program will aim to improve the quality of care of older patients in the investigators hospital by implementing focused interventions and recommendations specific to geriatric needs and syndromes, including: reduced fall rate, decreased incidence and duration of delirium, early recognition and treatment of impaired mobility and function, careful minimization of medication use, prevention of unnecessary catheter and restraint use, decreased hospital readmission rates, improved transitional care following hospital discharge, and high levels of patient and referring physician satisfaction. Additionally, the ACE program aims to improve resident and student competence in treating geriatric syndromes, and to improve staff and learner satisfaction with caring for older adults. ACE programs have been well studied at other institutions, so the investigators will be implementing a program that is already standard of care, and studying the elements that are unique to OHSU.

This will be a quality improvement project. Study participants will be a convenience sample of OHSU faculty, staff, residents and students who are employed by or on rotation with General Medicine Team 1 of the Medicine Teaching Service. Faculty, staff, and learners (ACE team members) will receive the ACE training. Study personnel will conduct prospective and retrospective chart review of patients admitted to the ACE service to determine outcomes as noted above.

Enrollment: 300 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (ACE faculty, health care providers and students):

• employed by OHSU or enrolled in one of OHSU's schools (medicine, nursing, pharmacy)
• share in the care of older adults on the General Medicine Team 1 service.

Inclusion Criteria (patients):

• admitted to the internal medicine service during the time frame of the study
• age 70 or older at time of hospital admission

Exclusion Criteria (ACE faculty, health care providers and students):

• non-English-speaking

Exclusion Criteria (patients):

• none

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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300 participants in 2 patient groups

ACE Service

Active Comparator group

Description:

Admission to the Acute Care for Elders (General Medicine Team 1) service. (See Intervention, below)

Treatment:

Other: Acute Care of Elders focused geriatric care

Standard care (other General Medicine teams)

No Intervention group

Description:

Admission to one of the 4 non-ACE general medicine teaching teams at OHSU.