Acute Care for Elders (ACE) Program at OHSU Hospital

NCT02119078 | Unknown

• 1 other identifier: RB00010420
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 1

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.

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

Outcome Measures

Primary Outcomes (1)

• Number of geriatric patients with adverse events

  Incidence and duration of delirium (source: hospital problem list); incidence of hospital-acquired pressure ulcers (source: nursing documentation, problem list); number of prescriptions for Beers List medications during hospitalization and upon discharge (source: MAR)

  During hospitalization, an expected average of 6 days

Secondary Outcomes (1)

• Resident confidence in treating geriatric syndromes

  After 3 week rotation on the Acute Care for Elders service

Study Arms (2)

ACE Service

ACTIVE COMPARATOR

Admission to the Acute Care for Elders (General Medicine Team 1) service. (See Intervention, below)

Other: Acute Care of Elders focused geriatric care

Standard care (other General Medicine teams)

NO INTERVENTION

Admission to one of the 4 non-ACE general medicine teaching teams at OHSU.

Interventions

Acute Care of Elders focused geriatric care OTHER

Patients admitted to the ACE Service will receive standard care as well as additional use of geriatric-specific order sets and protocols and oversight of care by a geriatric-trained Advanced Practice Provider (APP).

ACE Service

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

• non-English-speaking
• none

Sponsors & Collaborators

• Oregon Health and Science University: lead

Study Sites (1)

Oregon Health & Science University Hospital

Portland, Oregon, 97239, United States

Location

MeSH Terms

Conditions

Delirium; Drug-Related Side Effects and Adverse Reactions

Condition Hierarchy (Ancestors)

Confusion; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurocognitive Disorders; Mental Disorders; Chemically-Induced Disorders

Study Officials

• Juliana M Bernstein, MPAS, PA-C

  Oregon Health and Science University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, Physician Assistant

Study Record Dates

• First Submitted: April 8, 2014
• First Posted: April 21, 2014
• Study Start: January 1, 2014
• Primary Completion: June 30, 2017
• Study Completion: December 20, 2020
• Last Updated: November 4, 2019

Record last verified: 2019-10

Locations

US (1)