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If ACE Units Are So Great, Why Aren't They Everywhere?

Cheryl Clark, for HealthLeaders Media, April 25, 2013

"Now everyone has to make sure he hasn't injured himself, so he gets a head CT and an X-ray of his hip. That drives up costs. He's getting all these extra tests because he got a drug that would have worked fine in a 45-year old, but didn't in a 75-year-old with cognitive impairment.

"If he'd come to the ACE unit we would have given him Zofran instead," which wouldn't have prompted his confusion and loss of balance, Flood says. That's one way ACE units save money.

An emerging issue for Pierluissi, however, is that the proliferation of ACE units means each hospital is adopting their own version of the program, so it's hard to know which components works.

"Is it the pharmacist, or the person who pushed the patient to walk every day? If I have a limited amount of money and don't want to do the whole thing, what is it that really matters? It's hard to tease out what is the secret sauce."

"We don't know." There's no accreditation organization for ACE units. That will change, especially as healthcare reform penalties and incentive payments kick in at higher rates in coming years.

"All of the folks who have looked at the economics carefully show that it pencils out, and even more so in a setting of healthcare reform," Pierluicci says.

So why don't more hospitals have them?


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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1 comments on "If ACE Units Are So Great, Why Aren't They Everywhere?"


Diana Rosenkaimer (4/25/2013 at 12:56 PM)
This is neither a new concept but a necessary one. This was being done over 40 years ago at the Philadelphia Geriatric Center. There's nothing sexy about treating the elderly population, but it should be realized that the society that ignores their elderly is one that is doomed to failure of all of its citizens. Something the USA hasn't learned yet.