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Open AccessConcept Paper

ACE Model for Older Adults in ED

Icahn School of Medicine at Mount Sinai, Department of Geriatrics and Palliative Medicine 1, New York, NY 10029, USA
Icahn School of Medicine at Mount Sinai Department of Emergency Medicine2, New York, NY 10029, USA
Author to whom correspondence should be addressed.
Geriatrics 2019, 4(1), 24;
Received: 31 December 2018 / Revised: 1 February 2019 / Accepted: 13 February 2019 / Published: 21 February 2019
(This article belongs to the Special Issue Geriatric Care Models)
The emergency department (ED) is uniquely positioned to improve care for older adults and affect patient outcome trajectories. The Mount Sinai Hospital ED cares for 15,000+ patients >65 years old annually. From 2012 to 2015, emergency care in a dedicated Geriatric Emergency Department (GED) replicated an Acute Care for Elderly (ACE) model, with focused assessments on common geriatric syndromes and daily comprehensive interdisciplinary team (IDT) meetings for high-risk patients. The IDT, comprised of an emergency physician, geriatrician, transitional care nurse (TCN) or geriatric nurse practitioner (NP), ED nurse, social worker (SW), pharmacist (RX), and physical therapist (PT), developed comprehensive care plans for vulnerable older adults at high risk for morbidity, ED revisit, functional decline, or potentially avoidable hospital admission. Patients were identified using the Identification of Seniors at Risk (ISAR) screen, followed by geriatric assessments to assist in the evaluation of elders in the ED. On average, 38 patients per day were evaluated by the IDT with approximately 30% of these patients formally discussed during IDT rounds. Input from the IDT about functional and cognitive, psychosocial, home safety, and pharmacological assessments influenced decisions on hospital admission, care transitions, access to community based resources, and medication management. This paper describes the role of a Geriatric Emergency Medicine interdisciplinary team as an innovative ACE model of care for older adults who present to the ED. View Full-Text
Keywords: geriatric emergency care; IDT; transitional care; ACE model geriatric emergency care; IDT; transitional care; ACE model
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Sanon, M.; Hwang, U.; Abraham, G.; Goldhirsch, S.; Richardson, L.D.; Investigators, G.W. ACE Model for Older Adults in ED. Geriatrics 2019, 4, 24.

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