Delivering improved patient and system outcomes for hospitalized older adults through an Acute Care for Elders Strategy

Author:

Sinha Samir K.12,Bennett Jocelyn3,Ramsden Rebecca4,Bon Joanne5,Chalk Tyler6

Affiliation:

1. Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada.

2. Departments of Medicine, Family and Community Medicine and Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

3. Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

4. Department of Nursing, Sinai Health System, Toronto, Ontario, Canada.

5. Office of Patient Experience and Outcomes, Sinai Health System, Toronto, Ontario, Canada.

6. Office of Strategy, Southlake Regional Health Centre, Newmarket, Ontario, Canada.

Abstract

Acute care hospitals are widely recognized as potentially high-risk environments for older adults. In 2010, Mount Sinai Hospital conceived its Acute Care for Elders (ACE) Strategy as a multi-component intervention to improve the care of hospitalized older adults. In order to determine its effectiveness, we conducted a quasi-experimental time series analysis of 12,008 older patients admitted non-electively for acute medical issues over a 6-year period. Despite a 53% increase in annual admissions of older patients between 2009/2010 and 2014/2015, Mount Sinai decreased total lengths of stay and readmissions and reduced the direct cost of care per patient, leading to net savings of CDN$4.2 million in 2014/2015. This article presents Mount Sinai’s ACE Strategy and discusses the benefits of implementing integrated evidence-based models across the continuum of care and how it is supporting the implementation of ACE Strategy models of care and care practices across Canada and beyond.

Publisher

SAGE Publications

Subject

Health Policy

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