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

Cheryl Clark, April 25, 2013

In an interview, she explains how the program is better than traditional hospital care by giving two real life examples.

She was performing a geriatric consult in a non-ACE unit of the hospital about 3:30 on a Friday afternoon when she overheard a nurse discussing a patient with a doctor or social worker on the phone.

" 'Are we sending Mr. So-and-So home today?' the nurse asked. Hearing that he was scheduled for discharge, the nurse said, 'Well, do you know he's only got 88% on room air, (meaning that he was getting oxygen assistance).

"The person on the other end of the line apparently knew that, but said he had an oxygen unit at home. The nurse replied, 'No, he doesn't. Are you sure he has home oxygen?'

"You can see how uncoordinated and inefficient that was, and would never happen on an ACE unit. Now the patient has to stay another half a day or longer to sort out the home oxygen situation, and every minute he's in the hospital is costing the hospital more money," Flood says.

UAB's ACE team would have been talking about the patient's need for home oxygen on day one, and assessing his need for it every day, she says.

Flood gave another actual case to illustrate the ACE care difference.

A 75ish man with chemotherapy-related nausea comes in. He gets Ativan, an anti-anxiety drug that also treats cancer-associated nausea.

"But what no one realizes is that this man has cognitive impairment, and when he gets up to go to the bathroom, he gets confused, loses his balance and falls.

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