An Interdisciplinary Approach to Optimize Health Services in a Specialized Acute Care for Elders Unit
Clinical Practice
An Interdisciplinary Approach to Optimize Health Services in a Specialized Acute Care for Elders Unit
Roger Y. M. Wong, BMSc, MD, FRCPC; Maureen Shaw, RN, MN; Carol Acton, RN, MSN; Kerry Wilbur, BScPharm, PharmD; Mary McMillan, Dip PT; Emma Breurkens, BSc OT; Cheryl Sowden, OT, BSR; Semone Marie Trautman, BSW, MSW, RSW; Nicole Chan, BSc PT
Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver Hospital and Health Sciences Center, Vancouver, BC
Geriatrics Today, 6, 177-186
177 GERIATRICS Today: J CAN GERIATR SOC FD-Communications Inc. 2003
Background: Acute care for elders (ACE) units can maintain or promote function of acutely ill, older hospitalized patients. Our goal was to optimize interdisciplinary health services for frail elderly patients in a Canadian ACE unit.
Methods: A co-management physician practice model was adopted, which encourages collaboration between primary care providers (internists and family physicians) and consultants (specialists in geriatric medicine and geriatric psychiatry). Nursing practice was redesigned to focus on the functional, environmental and cognitive requirements of older patients, in addition to addressing acute nursing needs. Clinical pharmacists routinely monitor all ACE patients for adverse drug reactions and educate patients and families. Automatic physiotherapy screening assessment, and intervention when indicated, has been provided to all patients immediately upon admission, to prevent functional decline. Mobilization is a team effort with participation of patients, families and staff. Occupational therapists provide proactive interventions by routinely screening patients and intervening early when indicated. This includes providing appropriate equipment and liaising with community therapists. Social workers apply systems theory and use the genogram when dealing with families and patients, to help with effective discharge planning. There is enhanced collaboration with continuing care workers from the community.
Results and Conclusion: Early, routine assessment and intervention by different health disciplines in an ACE unit can preserve independence and function of older patients.
Key words Elderly, acute care, interdisciplinary team
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ACEProgram_JCanGeriatricSoc2003.pdf
