Upland, Pa. - The Acute Care of Elders (ACE) Unit at Crozer-Chester Medical Center recently celebrated its first year of providing specialized care for patients who are over the age of 65. Designed to be safe, comfortable and easy for seniors to use, the unit strives to decrease the risk of functional decline that sometimes occurs to seniors during hospitalization.
“The unit has had a tremendous first year,” says Sandra Evelyn, R.N., nurse manager of the ACE Unit. “Over the past year, we have changed everything about the unit, from how care is delivered to how staff communicate. We have implemented protocols to create an environment that is best for our patients. These changes have resulted in our patient satisfaction scores increasing by over 60 points, and physicians and patients specifically requesting admission to the unit.”
Some of the new initiatives that Evelyn attributes to the unit’s success includes hourly rounding by the staff to address any needs or patient concerns; removing the intercom system to reduce noise and disruption on the unit as well as to eliminate “voices coming out of the walls” for patients suffering from dementia; and adopting the philosophy of old-time nursing by giving patients a back rub, a warm drink and a warm blanket before lights out on the unit at 10 p.m.
“We are very proud of the unit’s success to date,” says William Zirker, M.D. MPH, chief of the Division of Geriatric Medicine at Crozer-Chester Medical Center and medical director of the ACE Unit. “In addition to increased patient and family satisfaction, our clinical outcomes are very positive. The unit takes a proactive approach to care, and when we see patients who were delirious, or in bed and deconditioned, now getting up, walking and reoriented, it’s very encouraging for everyone involved with the patient.”
Zirker adds that the unit has become a laboratory for inpatient geriatrics, and is benefiting patients as well as physicians, nurses, residents, physical and occupational therapists, and dietitians who visit the unit. “Our interdisciplinary team has become a source of geriatric training for all clinicians.”
As the unit enters its second year, the clinical staff continue to take a very active role in shaping the care provided to patients. Recently, the unit has introduced customized ACE Admission Orders for referring physicians. These orders are customized to reflect the hospital’s evidence based medicine initiatives, as well as unit-based protocols.
“The customized admission orders are a reflection of the success that we’ve had over the first year,” Evelyn says. “Because we remained virtually free of restraints and implemented an Agitated Patient Protocol, for example, we were then able to establish admission orders that reflect these changes.”
In addition to the new admission orders, the unit will also focus on working with physicians to implement and adapt to new protocols, as well as expand and strengthen best practice initiatives on the unit and throughout the health system.
“The unit is part of the hospital’s focus to become more elder-friendly,” Zirker says. “By piloting best practice initiatives on the unit, it is becoming a seeding ground for the health system. These successful best practices are then shared throughout the hospital and health system.”