Acute Care for Elders (ACE) Program at OHSU Hospital

October 31, 2019 updated by: Juliana Bernstein, Oregon Health and Science University

The purpose of this investigation is to assess the effectiveness of a multi-disciplinary Acute Care for Elders (ACE) program dedicated to the care of patients age 70 and older admitted to Oregon Health & Science University's hospital medicine service. The ACE program will aim to improve the quality of care of older patients in the investigators hospital by implementing focused interventions and recommendations specific to geriatric needs and syndromes, including: reduced fall rate, decreased incidence and duration of delirium, early recognition and treatment of impaired mobility and function, careful minimization of medication use, prevention of unnecessary catheter and restraint use, decreased hospital readmission rates, improved transitional care following hospital discharge, and high levels of patient and referring physician satisfaction. Additionally, the ACE program aims to improve resident and student competence in treating geriatric syndromes, and to improve staff and learner satisfaction with caring for older adults. ACE programs have been well studied at other institutions, so the investigators will be implementing a program that is already standard of care, and studying the elements that are unique to OHSU.

This will be a quality improvement project. Study participants will be a convenience sample of OHSU faculty, staff, residents and students who are employed by or on rotation with General Medicine Team 1 of the Medicine Teaching Service. Faculty, staff, and learners (ACE team members) will receive the ACE training. Study personnel will conduct prospective and retrospective chart review of patients admitted to the ACE service to determine outcomes as noted above.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

300

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Oregon
      • Portland, Oregon, United States, 97239
        • Oregon Health & Science University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria (ACE faculty, health care providers and students):

  • employed by OHSU or enrolled in one of OHSU's schools (medicine, nursing, pharmacy)
  • share in the care of older adults on the General Medicine Team 1 service.

Inclusion Criteria (patients):

  • admitted to the internal medicine service during the time frame of the study
  • age 70 or older at time of hospital admission

Exclusion Criteria (ACE faculty, health care providers and students):

  • non-English-speaking

Exclusion Criteria (patients):

  • none

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: ACE Service
Admission to the Acute Care for Elders (General Medicine Team 1) service. (See Intervention, below)
Other: Acute Care of Elders focused geriatric care
Patients admitted to the ACE Service will receive standard care as well as additional use of geriatric-specific order sets and protocols and oversight of care by a geriatric-trained Advanced Practice Provider (APP).
No Intervention: Standard care (other General Medicine teams)
Admission to one of the 4 non-ACE general medicine teaching teams at OHSU.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of geriatric patients with adverse events
Time Frame: During hospitalization, an expected average of 6 days
Incidence and duration of delirium (source: hospital problem list); incidence of hospital-acquired pressure ulcers (source: nursing documentation, problem list); number of prescriptions for Beers List medications during hospitalization and upon discharge (source: MAR)
During hospitalization, an expected average of 6 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Resident confidence in treating geriatric syndromes
Time Frame: After 3 week rotation on the Acute Care for Elders service
As measured by the Post-ACE Survey resident questionnaire, which includes 17 metrics of confidence (e.g. management of pain, identification of fall risk factors, delivering bad news, discussion of hospice care, performing a complete skin exam, documenting advanced directives, managing insomnia, performing bedside cognitive assessments.)
After 3 week rotation on the Acute Care for Elders service

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Oregon Health and Science University

Investigators

  • Principal Investigator: Juliana M Bernstein, MPAS, PA-C, Oregon Health and Science University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2014

Primary Completion (Actual)

June 30, 2017

Study Completion (Anticipated)

December 20, 2020

Study Registration Dates

First Submitted

April 8, 2014

First Submitted That Met QC Criteria

April 17, 2014

First Posted (Estimate)

April 21, 2014

Study Record Updates

Last Update Posted (Actual)

November 4, 2019

Last Update Submitted That Met QC Criteria

October 31, 2019

Last Verified

October 1, 2019

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • RB00010420

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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