Summa opened its first ACE unit in 1994 with the goal to prevent loss of personal independence and physical strength that can occur during routine hospitalization of older adults. The ACE Model's key components include comprehensive multidimensial assessment, functionally oriented patient-centered care, an interdisciplinary team that meets daily, a prepared environment that promotes functional independence, and early comprehensive transitional care planning for the next level of care. Attributes of the unit include a home-like atmosphere with non-slip carpeted hallways, cozy alcoves and a working kitchen area. With the innovative design, older patients are encouraged to maintain self-care abilities, social skills and independence while recuperating from illness and injury.
Dr. Kyle Allen, chairman of the department of geriatric medicine, says the parallels between ACE units and stroke units are not surprising.
"Both models of care seek to improve functional outcomes of hospitalized patients with complex medical and functional problems," said Allen. "Stroke and its common complications can leave hospitalized older adults vulnerable to negative outcomes because of their decreased functional and physiological reserves."
As with Summa's ACE unit, Allen and his team created a prepared environment, use of patient-centered care, incorporation of nursing care plans for rehabilitation and prevention of disability, stroke specific treatment guidelines for common conditions such as blood pressure management, swallowing evaluations, and prevention of blood clots and pneumonia, interdisciplinary team management with daily team rounds, early planning for discharge home, medical and treatment guidelines to optimize stroke care, and review of medical care to prevent illness.
The stroke unit also underwent major renovations with costs offset by philanthropic gifts. The renovations included the addition of a six-bed neurology step-down unit. Other features of the renovation included a home-like lounge, with comfortable furniture and a kitchen like setting that encourages early rehabilitative care and social interaction; a private consultation room, where patients, their families and their physicians can meet to discuss confidential issues; and carpeted hallways that promote patient mobility.
The dedicated 34-bed Summa stroke unit discharges nearly 1,000 patients per year who have suffered hemorrhagic or ischemic stroke or transient ischemic attack (TIA). Summa treats more patients for stroke than any other Northeast Ohio hospital.
The article is available at http://www.eurekalert.org/images/release_graphics/sha110403.pdf.
Summa Health System is one of the largest organized delivery systems in Ohio. Recently ranked as the 22nd best geriatric program in the nation and 19th in the nation for neurology by U.S. News and World Report, Summa Health System is one of the largest organized delivery systems in Ohio.
Journal
Journal of the American Geriatrics Society