What defines an ACE ward?
An Acute Care for Elders (ACE) ward is more than just a typical hospital floor with older patients. It is a system of care and a designated physical environment optimized for the specific needs of elderly patients. The fundamental goal is to maintain or restore the patient's functional abilities, independence, and quality of life while treating their acute medical condition. It is a proactive model, addressing risks common in older adults, such as delirium, falls, and pressure ulcers, rather than just reacting to them.
The interdisciplinary team
One of the core principles of an ACE ward is its interdisciplinary team-based approach. This model brings together a wide range of healthcare professionals who collaborate daily to create and execute a comprehensive care plan for each patient. This team typically includes:
- Geriatricians: Doctors with specialized training in the health care of older adults.
- Geriatric Nurses and Nurse Practitioners: Nurses with enhanced skills in caring for elderly patients.
- Pharmacists: Specially trained to review medication lists and prevent harmful drug interactions, which is crucial for older adults often taking multiple medications (polypharmacy).
- Physical and Occupational Therapists: Focus on maintaining mobility and functional independence.
- Social Workers and Case Managers: Coordinate discharge planning, resources, and support services to ensure a safe transition home or to the next level of care.
- Dietitians: Address nutritional needs, which are critical for recovery.
- Patient Care Associates: Provide hands-on care with geriatric-specific training.
The 'elder-friendly' environment
The physical design of an ACE ward is purposefully modified to create a safer, more comfortable, and stimulating environment for seniors. These features are designed to mitigate risks and encourage recovery. Examples of environmental adaptations include:
- Reduced noise and lighting: Floors and windows with glare-resistant materials to reduce visual and auditory overstimulation.
- Safety features: Grab bars in bathrooms and contrasting colors on items like toilet seats to reduce fall risk.
- Communal spaces: Features like communal dining areas or gardens to promote socialization and physical activity.
- Promoting mobility: Floors are often designed to be less slippery and patients are encouraged to get up and walk multiple times a day with assistance.
Benefits for the patient
Studies have consistently demonstrated that patients treated in ACE wards experience significantly better health outcomes compared to those in standard hospital units. Key benefits include:
- Reduced functional decline: Patients are more likely to return home with preserved or improved functional ability, rather than being discharged to a nursing home.
- Lower rates of hospital-acquired complications: ACE units have fewer incidents of delirium, falls, and pressure ulcers.
- Shorter length of stay: The efficient, targeted care model often leads to a quicker recovery.
- Fewer readmissions: Better discharge planning and education contribute to fewer patients needing to be readmitted to the hospital.
- Increased satisfaction: Both patients and their families often report higher satisfaction with the level of care and communication received.
Who is eligible for an ACE ward?
While specific criteria may vary slightly between hospitals, eligibility for an ACE ward generally targets older adults with an acute medical problem that requires hospitalization. Patients are typically over a certain age, often 70 or 75, and do not require intensive care treatment. Patients are recruited upon admission through electronic protocols or during assessment in the emergency department, with a focus on those showing signs of functional decline, cognitive changes, or common geriatric issues.
ACE Ward vs. Standard Hospital Ward
| Feature | ACE Ward | Standard Hospital Ward |
|---|---|---|
| Patient Focus | Primarily older adults (e.g., 70+ years old) | All adult ages |
| Care Model | Interdisciplinary, geriatric-focused team | Care by generalist doctors and nurses |
| Environment | Specially adapted for seniors (lower glare, safety features) | Standard hospital room design |
| Primary Goal | Prevent functional decline; maintain independence | Treat primary medical diagnosis |
| Risk Management | Proactive screening for delirium, falls, etc. | Reactive response to complications |
| Discharge Planning | Begins at admission; highly comprehensive | Initiated closer to discharge date |
| Outcomes | Better functional and cognitive outcomes; lower complication rates | Greater risk of functional decline; higher complication rates |
Conclusion
In summary, an ACE ward represents a proactive and specialized approach to senior health care that addresses the unique vulnerabilities of older adults during hospitalization. By focusing on maintaining independence and preventing common hospital-acquired complications through an interdisciplinary team and a tailored environment, ACE wards have demonstrated superior outcomes. For family members seeking the best care for an elderly loved one, understanding what an ACE ward is and its proven benefits can be invaluable in advocating for better hospital experiences and outcomes. You can find more information on the model and its impact from health organizations like The Commonwealth Fund, which supports innovations in healthcare delivery. [https://www.commonwealthfund.org/publications/international-innovation/2020/oct/acute-care-elders-ace]
