Some hospitals are trying to improve inpatient care for seniors with teams that work with elderly patients throughout the hospital or in specific service lines to prevent some of the common complications in this population. A study published in the June 10, 2013, issue of JAMA Internal Medicine found that one such model — Mount Sinai Hospital’s mobile acute care for the elderly service — improved some outcomes but didn’t affect others.
What is mobile acute care for the elderly?
The team consists of geriatricians, social workers and clinical nurse specialists who work with hospitalized patients from the hospital’s outpatient geriatrics practice. It focuses on reducing hospitalization risks, improving care transitions and discharge planning, improving care coordination with outpatient practices, and educating patients and caregivers.
How was the study conducted?
The study ran from November 2008 to August 2011. It compared the mobile acute care service with usual care between 173 matched pairs of patients.
What were the results?
Adverse events: The mobile acute care service outperformed usual care in all the adverse events studied — catheter-associated urinary tract infections, restraint use, falls and new pressure ulcers. The overall percentage of adverse events was 9.5 percent among mobile acute care patients, compared with 17 percent of patients getting usual care.
Functional status: The study measured no significant difference between the two patient groups at 30 days after discharge.
Length of stay: The mean length of stay was 0.8 days shorter among patients managed by the mobile acute care service, compared with patients receiving usual care.
Readmissions: No significant difference in 30-day readmission rates was observed between the two groups of patients.
Patient satisfaction: No significant difference was found between the two groups’ overall hospital rating, as measured by the national Hospital Consumer Assessment of Healthcare Providers and Systems. However, the mobile acute care service significantly outperformed usual care in “top box” results in several HCAHPS survey categories, including nursing, medication communication and discharge.