Clinical trial NCT02119078: Acute Care for Elders (ACE) Program at OHSU Hospital
Official title: Acute Care for Elders (ACE) Program at OHSU Hospital
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Delirium
Age-Related Cognitive Decline
Frail Elderly
Hospital Acquired Pressure Ulcer
Drug-Related Side Effects and Adverse Reactions
Keywords: Geriatrics
Acute Care for Elders
Geriatric syndromes
Delirium
Falls
Polypharmacy
Lead sponsor: Oregon Health and Science University
Sponsor class: OTHER
First posted: 2014-04-21
Enrollment: 300
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this investigation is to assess the effectiveness of a multi-disciplinary Acute Care for Elders (ACE) program dedicated to the care of patients age 70 and older admitted to Oregon Health \& Science University's hospital medicine service. The ACE program will aim to improve the quality of care of older patients in the investigators hospital by implementing focused interventions and recommendations specific to geriatric needs and syndromes, including: reduced fall rate, decreased incidence and duration of delirium, early recognition and treatment of impaired mobility and function, careful minimization of medication use, prevention of unnecessary catheter and restraint use, decreased hospital readmission rates, improved transitional care following hospital discharge, and high levels of patient and referring physician satisfaction. Additionally, the ACE program aims to improve resident and student competence in treating geriatric syndromes, and to improve staff and learner satisfaction with caring for older adults. ACE programs have been well studied at other institutions, so the investigators will be implementing a program that is already standard of care, and studying the elements that are unique to OHSU.

This will be a quality improvement project. Study participants will be a convenience sample of OHSU faculty, staff, residents and students who are employed by or on rotation with General Medicine Team 1 of the Medicine Teaching Service. Faculty, staff, and learners (ACE team members) will receive the ACE training. Study personnel will conduct prospective and retrospective chart review of patients admitted to the ACE service to determine outcomes as noted above.


Eligibility criteria: Inclusion Criteria (ACE faculty, health care providers and students):

* employed by OHSU or enrolled in one of OHSU's schools (medicine, nursing, pharmacy)
* share in the care of older adults on the General Medicine Team 1 service.

Inclusion Criteria (patients):

* admitted to the internal medicine service during the time frame of the study
* age 70 or older at time of hospital admission

Exclusion Criteria (ACE faculty, health care providers and students):

* non-English-speaking

Exclusion Criteria (patients):

* none

Primary outcomes:
measure: Number of geriatric patients with adverse events
timeFrame: During hospitalization, an expected average of 6 days
Secondary outcomes:
measure: Resident confidence in treating geriatric syndromes
timeFrame: After 3 week rotation on the Acute Care for Elders service
Other outcomes:
Locations:
city: Portland
country: United States
facility: Oregon Health & Science University Hospital
state: Oregon
Study officials:
affiliation: Oregon Health and Science University
name: Juliana M Bernstein, MPAS, PA-C
role: PRINCIPAL_INVESTIGATOR
References: