Developing a Stroke Unit Using the Acute Care for Elders Intervention and Model of Care

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 51; no. 11; pp. 1660 - 1667
• Main Authors: Allen, Kyle R., Hazelett, Susan E., Palmer, Robert R., Jarjoura, David G., Wickstrom, Glenda C., Weinhardt, Jan A., Lada, Robert, Holder, Carolyn M., Counsell, Steven R.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Inc 01.11.2003; Blackwell; Wiley Subscription Services, Inc
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Elder care; Elderly people; Emergency and intensive care: techniques, logistics; Female; Geriatrics; hospital care; Hospital Units - organization & administration; Hospital Units - standards; Hospitalization; Humans; Intensive care medicine; Intensive care unit. Emergency transport systems. Emergency, hospital ward; inter-disciplinary team; Interdisciplinary team work; Male; Medical sciences; Miscellaneous; Older people; Outcomes; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of care; Randomized Controlled Trials as Topic; Rehabilitation; Stroke; Stroke - mortality; Stroke - therapy; stroke unit; Stroke units; Strokes; Treatment Outcome; USA; United States; North America; America; Human; Performance evaluation; Stroke; Statistical analysis; Organization; Application method; Elderly; Comparative study; Intensive care unit
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1046/j.1532-5415.2003.51521.x

The Acute Care for Elders (ACE) model of care is a multicomponent intervention that improves outcomes for older patients hospitalized for acute medical illnesses. Likewise, stroke units improve outcomes for patients with acute stroke, yet the descriptions of their structure and approach to stroke management are heterogeneous. The purpose of this article is to describe how implementing the ACE model of care, using a continuous quality‐improvement process, can serve as a foundation for a successful stroke unit aimed at improving stroke care. The ACE intervention (a prepared environment, interdisciplinary team management, patient‐centered nursing care plans, early discharge planning, and review of medical care) was amplified in a community teaching hospital for stroke‐specific care by creating a stroke interdisciplinary team, evidence‐based stroke orders and protocols, and a redesigned environment. Administrative data show that the ACE model can be successfully adapted to create a disease‐specific program for stroke patients, having the potential to improve the process of care and clinical stroke outcomes.