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

Cheryl Clark, for HealthLeaders Media, April 23, 2013

Hung says that his research group could not yet say whether having a MACE unit reduces overall cost of care, the topic of a separate research project. But he says it probably does in a high occupancy hospital that will promptly fill an empty bed once a patient is discharged.

The second study, conducted at the 1,114-bed University of Alabama at Birmingham by Kellie Flood, MD, and colleagues, looked at costs and 30-day readmissions in patients treated within a special 25-bed ACE unit, versus a similar group of elderly patients treated in usual care hospital settings.

An interdisciplinary team in an ACE unit, they concluded, "significantly reduces variable direct costs and 30-day readmission rates for patients 70 years or older" by about $371 per patient, or the difference between $2,480 and $2,109 per DRG.

For every 400 patients admitted to an ACE unit, the amount saved would be $148,400. The interdisciplinary team consists of an ACE nurse coordinator, geriatricians, nurses, physical and occupational therapists, pharmacists, a registered dietician, and social workers.

The ACE unit team provided geriatric assessments including cognitive and functional exams, geriatrician-led rounds focusing on geriatric care five days a week, discharge planning starting on the day of admission, and communication of team recommendations to the appropriate caregiver.

For the control group, hospitals admitted patients of all ages to usual care units, which were staffed with the same disciplines. "But geriatric screens and daily interdisciplinary team rounds focusing on geriatric syndromes were not conducted, nor were the volunteer-staffed care processes used."

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