Sinha Samir K, Bennett Jocelyn, Ramsden Rebecca, Bon Joanne, Chalk Tyler
1 Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada.
2 Departments of Medicine, Family and Community Medicine and Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Healthc Manage Forum. 2018 Jul;31(4):126-132. doi: 10.1177/0840470418773108.
Acute care hospitals are widely recognized as potentially high-risk environments for older adults. In 2010, Mount Sinai Hospital conceived its Acute Care for Elders (ACE) Strategy as a multi-component intervention to improve the care of hospitalized older adults. In order to determine its effectiveness, we conducted a quasi-experimental time series analysis of 12,008 older patients admitted non-electively for acute medical issues over a 6-year period. Despite a 53% increase in annual admissions of older patients between 2009/2010 and 2014/2015, Mount Sinai decreased total lengths of stay and readmissions and reduced the direct cost of care per patient, leading to net savings of CDN$4.2 million in 2014/2015. This article presents Mount Sinai's ACE Strategy and discusses the benefits of implementing integrated evidence-based models across the continuum of care and how it is supporting the implementation of ACE Strategy models of care and care practices across Canada and beyond.
急症医院被广泛认为是老年人潜在的高风险环境。2010年，西奈山医院构思了其老年人急症护理（ACE）策略，作为一项多方面的干预措施，以改善住院老年人的护理。为了确定其有效性，我们对6年期间因急性医疗问题非选择性入院的12008名老年患者进行了准实验性时间序列分析。尽管2009/2010年至2014/2015年期间老年患者的年入院人数增加了53%，但西奈山医院缩短了总住院时间和再入院率，并降低了每位患者的直接护理成本，在2014/2015年实现了420万加元的净节省。本文介绍了西奈山医院的ACE策略，并讨论了在整个护理连续过程中实施综合循证模式的益处，以及它如何支持加拿大及其他地区ACE策略护理模式和护理实践的实施。
