Quinte Health Care News
Planning for Quinte Health Care's new Acute Care for Elders (ACE) unit is well underway
DID YOU KNOW?
- 30-60% of older people experience functional decline when acutely hospitalized
- One year after hospital discharge, less than 50% of older adults recover to their pre-illness level of functioning
- Up to 50% of older adults experience functional decline during hospitalization that is largely independent of their presenting medical illness
With a target date of April 12, planning is well underway as staff work to create a new ACE unit on Quinte 4 at Belleville General Hospital. Acute Care for Elders (ACE) is an evidence-based approach to care designed specifically to meet the needs of the hospitalized elderly patient with the goal of reducing function decline, hospital acquired disability and preventable need for Long-Term Care upon discharge.
The Acute Care for Elders program, which involves both environmental redesign and process changes, will eventually be rolled out to all QHC acute care areas. Christine Wilkinson, Director and ACE project sponsor said that the ACE program will include high-risk screening, assessment and restorative interventions and will target syndromes and other matters that commonly affect elderly people such as mobility, frailty, dementia, delirium, nutrition, and caregiver support. “Such practices as encouragement to get out of bed during mealtime, normalized routines and activities, enhanced toileting routines to minimize the use of bed pans/catheters and enhanced medication review are just a few of the practices that elderly patients at QHC can expect as we strive to enhance care for seniors,” said Wilkinson. The ACE philosophy will also include enhanced education and support for patients and family members with more attention placed on engaging patients and their families in decisions and ensuring they are supported to express their wishes.
Teams have already started the process of reviewing the physical environment of the new ACE unit which will include raised toilet seats, well-positioned handrails, a chair in each room in order to promote getting out of bed for meals, a common room, a separate dining room and clear signage. The ACE unit will include 30 beds (20 ACE and 10 Alternate Level of Care (ALC)) and will be staffed according to the Interprofessional Patient Care Team model whereby teams will work together to provide the patients and families with holistic, coordinated care.
How is this different than what we are currently doing or what we’ve done before?
The key to the Acute Care for Elders program is that the care and the environment supports not only treating a patient’s medical illness but also maintaining independence and preventing loss of abilities. We know that older patients are at a high risk of specific complications such as loss of mobility, delirium, malnutrition/dehydration. The ACE program will guide how the interprofessional team identifies these risks for each person and works together with the patient and the family to build and carry out a care plan that will address these needs.
Adrienne Bell-Smith, Manager of the Behavioural Supports Transition Unit and ACE implementation team member, said that the ACE program is not an “extra” service that is layered on top of our medical unit processes, rather, it is designing care specifically for this population. “One of the risk factors that will be screened for on admission, for example, will be mobility. If it is identified that risk of loss of mobility or low mobility is a concern for a patient, the team will incorporate specific actions into the patient’s care plan such as going to the dining room for lunch or dinner, sitting in a chair for breakfast, walking to the bathroom and one lap around the unit three times per day, for example.” Each member of the team, which will include family members, volunteers and others who have contact with the patient, will do what they are able to help each patient achieve their goals. Additionally, the team will review and address contributing factors that prevent mobilization – does the patient have medical tethers that could be removed (e.g. bedrails, IV, Catheter, Oxygen, sedating medications), are devices, footwear and clothing available? ACE is all about the team working together to develop and carry out a daily plan for each patient.
What is the connection between Acute Care for the Elderly (ACE) and NICHE?
As communicated last week, Quinte Health Care has received NICHE (Nurses Improving Care for Healthsystem Elders) designation which means that we have made a commitment to improve the way we care for seniors. Being “NICHE designated” does not mean that we’re already there – we still have work to do in order to reach our goal of becoming a senior friendly hospital.
More than 60 QHC staff including nurses, Personal Support Workers (PSWs) and therapy staff have been identified as NICHE champions, and will be completing a 20 hour education certificate program which will earn them a Geriatric Resource Nurse Certificate or a Geriatric Patient Care Associate Certificate.