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Hospital 'ACE' Teams Curb Adverse Events, LOS, Costs

Cheryl Clark, for HealthLeaders Media, April 23, 2013

"The MACE service does offer an alternative for hospitals that don't have an ACE unit developed and want to be able to serve older adults with significant health problems better," Hung says. "It's a much more transportable model."

Hung explains that Mount Sinai had a special dedicated ACE unit for about eight years, but disbanded it in 2006 because it was too resource-intensive, and its beds were frequently needed by younger, non-frail patients who didn't need those targeted services.

So this was the MACE was deployed. The experiment paired a group of 173 frail, elderly patients who received care from the MACE unit with a matched group of 173 who received usual care.

There were 17.06 adverse events of any kind in the group receiving usual care, but only 9.5 in the MACE group. For CAUTIs, the usual care group developed 4.6 while the MACE group had 1.7. As for use of restraints, the usual care group had 2.9 compared with .6 and for falls. The usual care group had 10.9 compared with 8.7 in the MACE group.

Patient experience scores were higher in the MACE group as well, especially in questions about how well physicians and nurses communicated.

Length of stay in the MACE group was two days shorter. Patients stayed in the hospital 4.6 days instead of 6.8 for the usual care group.

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