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Systems Addressing Frail Elder Care: Description of a Successful Model
Lianna Zaven Ansryan1, Harriet Udin Aronow, Jeff Edward Borenstein
1Author Affiliations: Clinical Nurse Specialist (Ms Ansryan), Department of Nursing Research, Cedars-Sinai, Los Angeles, CA; Research Scientist IV (Dr Aronow), Department of Nursing Research, Cedars-Sinai, Los Angeles, CA; Physician, General Internal Medicine, Associate Clinical Professor of Medicine, UCLA (Dr Borenstein), Department of Medicine, Cedars-Sinai, Los Angeles, CA; Clinical Nurse Specialist Student (Ms Mena) Mount St. Mary's School of Nursing, Los Angeles, CA; Nurse Educator, NICHE Coordinator (Ms Haus), Geri and Richard Brawerman Nursing Institute, Cedars Sinai Health System, Los Angeles, California, Clinical Pharmacist (Dr Palmer), Department of Pharmacy Services, Cedars-Sinai, Los Angeles, CA; Clinical Social Worker (Ms Chan), Department of Case Management and Social Work, Cedars-Sinai, Los Angeles, CA; Executive Director, Geri and Richard Brawerman Nursing Institute (Dr Swanson), Department of Nursing, Cedars-Sinai, Los Angeles, CA; Director, Social Work/Case Management (Dr Mass), Department of Case Management and Social Work, Cedars-Sinai, Los Angeles, CA; Vice President of Physician Alignment and Care Transitions, Medical Director ISP Hospitalist Service, Medical Director of Supportive Care Medicine (Dr Rosen), Department of Medicine, Cedars-Sinai, Los Angeles, CA; Vice President of Clinical Innovations (Dr Braunstein), Department of Medicine, Cedars-Sinai, Los Angeles, CA; Senior Vice President, Nursing and System Chief Nursing Executive James R. Klinenberg, MD & Lynn Klinenberg-Linkin Endowed Chair in Nursing (Dr Burnes Bolton), Department of Nursing, Cedars-Sinai, Los Angeles, CA.
The Systems Addressing Frail Elder (SAFE) Care model improves care for hospitalized older adults by using an interprofessional team. This approach reduced length of stay and complications, offering a framework for managing frailty risks.
Area of Science:
- Gerontology
- Healthcare Management
- Interprofessional Care
Background:
- Hospitalized older adults are susceptible to frailty-related adverse events.
- The Systems Addressing Frail Elder (SAFE) Care model is an interprofessional team-based program.
- Previous cluster randomized controlled trials (C-RCTs) demonstrated reduced length of stay and complications with the SAFE Care model.
Purpose of the Study:
- To describe the Systems Addressing Frail Elder (SAFE) Care model.
- To detail the interprofessional team composition and reengineered workflow.
- To encourage replication and implementation of the SAFE Care model or similar organizational changes.
Main Methods:
- Review of SAFE Care model features.
- Abstraction of intervention data from electronic health records.
Main Results:
- The C-RCT included 792 patients; 307 received the SAFE Care huddle intervention.
- Mobility issues were the most frequent problem identified (85.7%).
- Fall precautions protocol was the most frequent recommendation (83.1%).
Conclusions:
- The SAFE Care model offers a standardized framework for hospitalized older adults.
- It facilitates the assessment and management of frailty-related risks.
- The model supports a structured approach to improving care for this vulnerable population.
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