ACE Units are general medical units specifically for older adults. These units typically have the following components:
An interprofessional team: physician, advance practice nurse, physician assistant, physical therapist, occupational therapist, speech therapist, nutritionist, social worker, pharmacist and nurses.
Focus on functional ability: daily PT/OT starting on the day of admission
Discharge planning: starts on admission day with goal of returning to the community.
A thorough pharmaceutical review: usually in conjunction with a pharmacist to check dosages, therapeutic levels, side effects, and drug interactions
A prepared environment designed to facilitate physical and cognitive function: large clocks and calendars, handrails, raised toilet seats, and other environmental modification to assist the older patient.
- First started in 1989 at the University Hospitals of Cleveland
- Clinical and cost-effective benefits include:
- Fewer medications at discharge
- Reduced prevalence and duration of delirium
- Decreased length of stay
- Decreased re-admission rate
- Decreased nursing home placement
- Better functional capacity including improved ambulation and ability to perform instruments of daily living
- Better pain satisfaction scores.
- Cost savings are realized by increased discharges to home versus long-term care, decreased length of stay, and decreased readmissions.