Improving Geriatric Care Processes on Two Medical-Surgical Acute Care Units: A Pilot Study.

Area of Science:

• Geriatric Medicine
• Healthcare Innovation
• Quality Improvement

Background:

• The Acute Care for Elders (ACE) Unit model enhances cognitive and functional outcomes in hospitalized older adults.
• However, the reach of traditional ACE Units is limited, necessitating scalable dissemination strategies.

Purpose of the Study:

• To pilot the "Virtual ACE Intervention" to disseminate ACE Unit principles to non-ACE units.
• To standardize care processes for cognition and function without requiring daily geriatrician oversight.

Main Methods:

• The Virtual ACE Intervention involved staff training on geriatric assessments and nurse-driven care algorithms.
• Geriatric assessment completion, patient mobility, and delirium screening scores were compared pre- and post-intervention in patients aged 65 years and older.

Main Results:

• Post-intervention, geriatric assessment completion for functional status and delirium significantly improved (88.5% and 96.5%, respectively; p < .001).
• In a subsample, post-intervention mobility increased (patients up to chair: 63.5% vs. 36.4%; p = .04), and abnormal delirium scores decreased (4.8% vs. 13.6%; p = .16).

Conclusions:

• The Virtual ACE Intervention is a feasible model for extending ACE Unit principles to non-ACE settings.
• This intervention may improve adherence to geriatric care processes and enhance clinical outcomes for hospitalized elders.