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Unit designed for patients over 65 who are at high risk of complications
Palmetto Health is transforming a 30-bed medical unit into an Acute Care for the Elderly (ACE) unit at Palmetto Health Richland. The unit is designed to provide better, more specialized care for elderly acute care patients who are 65 and older and are at high risk for complications. The ACE unit is focused on daily interdisciplinary rounds, incorporating patient preferences during hospitalization, early mobility, nutrition and implementation of technology.
The unit will increase communication among staff by utilizing face-to-face, daily bedside rounding with ACE team members. This method allows the team to evaluate the patient’s needs and response to treatment more thoroughly. Each day, the team will briefly review each patient’s progress to determine the next step in his or her treatment. With more efficient communication, the effectiveness of the treatment is likely to improve which could in turn reduce the length of stay and recovery time. To promote early mobility, staff members encourage patients to be out of bed for meals and to walk in the hallways several times daily. By measuring length of time spent walking and number of steps taken, the ACE team can ensure that patients are as safely active as possible.
“When it comes to elderly patients, there needs to be a lot more focus on nutrition, sleep, delirium prevention and early mobility,” said Victor Hirth, M.D., Medical Director of Geriatric Services and Chief of the Division of Geriatrics at the University of South Carolina School of Medicine. “The normal hospital system isn’t designed to anticipate problems of older adults or deal with them. The ACE unit is really much more prevention focused. When you address potentially inappropriate medications, promote early mobility, nutrition, sleep, delirium and other aspects of care, lots of things improve including length of stay, and readmission rates. It’s hard to know exactly which factor contributes the most because it’s really the program in its entirety that contributes to improvements.”
Palmetto Health and other hospitals nationwide are experiencing an increase in age of acute care patients. The number of those patients suffering from co-morbidity, frailty, malnutrition and functional decline also is increasing. The length of stay for older patients in the Palmetto Health system is on average one to two days longer than younger patients. The new ACE Unit is expected to reduce length of stay, decrease readmissions, lower cost of hospitalization and improve quality outcomes. The results found from studies in other hospitals show that similarly designed units have proven to do all of these.
Palmetto Health NICHE (Nurses Improving Care for Healthsystem Elderly) program coordinator Donna Wolff adds, “One of the main goals of our unit is to work together as a team in real time so that we are aware of what is going on for that patient at that moment. This way, we know what is on the mind of the geriatrician, the nurse, the rehab therapist, the social worker, the pharmacist and everyone else on the team so that we can make a better decision on what’s next for that patient.”
About Palmetto Health
Palmetto Health, the largest health care system in the Midlands and third largest non-governmental employer in South Carolina, is composed of more than 10,000 team members, physicians and volunteers working together to fulfill Palmetto Health’s vision: to be remembered by each patient as providing the care and compassion we want for our families and ourselves. The system includes four acute-care hospitals—Palmetto Health Baptist, Palmetto Health Children’s Hospital, Palmetto Health Heart Hospital and Palmetto Health Richland—as well as an expansive physician practice network, dozens of affiliated clinics and specialty care practices and a 501(c)(3) foundation. Palmetto Health Baptist Parkridge, the region’s newest hospital located in northwest Columbia, is scheduled to open spring 2014. Recognized nationally as one of the best places to work and receive care, Palmetto Health also trains the next generation of physicians through its 23 residency and fellowship programs affiliated with the University of South Carolina School of Medicine.