New software helps reduce risks for older patients
Dr. Samir Sinha reviews his patient’s care plan with his team in Mount Sinai’s Acute Care for Elders (ACE) Unit, which offers frail older adults customized care in an elder friendly environment (Photo: Kevin Kelly)
Older adults (age 65+) make up 60 per cent of patients in Canadian hospitals. They also consume nearly half of public spending on healthcare as they often face multiple health issues and need more complex types of health services including hospital care where their complexity often requires longer hospital stays too. More time that is spent in hospitals also puts this group at an increased risk of developing further complications, such as immobility and delirium, as well as their likelihood of returning to hospital and perhaps not even returning home. “As our population ages, acute care hospitals need to transform how they resource, organize, and deliver care for older adults so that they can get better quicker and return to their homes safely with the right supports in place,” says Dr. Samir Sinha, Director of Geriatrics at Mount Sinai Hospital.
As part of Mount Sinai’s ongoing efforts to improve the way care is delivered to older patients, Mount Sinai has become Canada’s first hospital to launch ACE Tracker, a new computer program that will improve the way clinicians are able to identify and care for this high-risk group.
Instead of reviewing patient charts one-by-one, within minutes the ACE Tracker software identifies all patients in the hospital who are 65 years old and older and scans each patient’s record for common health vulnerabilities that older adults face. The program’s comprehensive checklist includes scanning for high-risk issues such as pain, history of falls, functional loss, cognitive impairments, length of stay and medication. ACE Tracker then assembles all relevant data into reports that present all the issues on a single line for each patient. The reports are generated in real-time and can be done for any unit of the hospital. “ACE Tracker allows any practitioner to understand health risks of their older patients so that they can better customize treatment plans and improve the quality of care their older patients receive,” says Rebecca Ramsden the ACE Unit’s Nurse Practitioner.
ACE Tracker is just another example of how Mount Sinai has been developing and integrating new approaches to address the growing health care needs of an aging population. In 2010 Mount Sinai launched its Acute Care for Elders (ACE) Strategy to ensure caring for older patients is maximized with an inter-professional, team-based approach, no matter where patients are cared for across the continuum, such as in the emergency department, in a hospital unit or at home. Much of this collaborative work has been facilitated through the development of innovative IT communication tools and hospital protocols that encourage mobility and promotes independence.
As a result of Mount Sinai’s innovative elder friendly approaches the hospital has seen dramatic improvements in its lengths of stay, overall quality of care and patient satisfaction levels for its older patients. These initiatives have also saved the hospital and health care system millions of dollars each year, mainly through achieving 28 per cent reduction in the overall lengths of hospital stays for those 65+. In building on these successes, Dr. Sinha believes that “ACE Tracker will be another tool that can be used by all members of our inter-professional teams to look at patients through a geriatric lens more quickly and efficiently and help improve outcomes for this vulnerable group.”
