Systems Addressing Frail Elder Care: Description of a Successful Model.

Lianna Zaven Ansryan Harriet Udin Aronow Jeff Edward Borenstein Viola Mena Flora Haus Katherine Palmer Ellen Chan Jane W Swanson Sharon Mass Bradley Rosen Glenn David Braunstein Linda Burnes Bolton

J Nurs Adm

Author Affiliations: Clinical Nurse Specialist (Ms Ansryan), Department of Nursing Research, Cedars-Sinai, Los Angeles, CA; Research Scientist IV (Dr Aronow), Department of Nursing Research, Cedars-Sinai, Los Angeles, CA; Physician, General Internal Medicine, Associate Clinical Professor of Medicine, UCLA (Dr Borenstein), Department of Medicine, Cedars-Sinai, Los Angeles, CA; Clinical Nurse Specialist Student (Ms Mena) Mount St. Mary's School of Nursing, Los Angeles, CA; Nurse Educator, NICHE Coordinator (Ms Haus), Geri and Richard Brawerman Nursing Institute, Cedars Sinai Health System, Los Angeles, California, Clinical Pharmacist (Dr Palmer), Department of Pharmacy Services, Cedars-Sinai, Los Angeles, CA; Clinical Social Worker (Ms Chan), Department of Case Management and Social Work, Cedars-Sinai, Los Angeles, CA; Executive Director, Geri and Richard Brawerman Nursing Institute (Dr Swanson), Department of Nursing, Cedars-Sinai, Los Angeles, CA; Director, Social Work/Case Management (Dr Mass), Department of Case Management and Social Work, Cedars-Sinai, Los Angeles, CA; Vice President of Physician Alignment and Care Transitions, Medical Director ISP Hospitalist Service, Medical Director of Supportive Care Medicine (Dr Rosen), Department of Medicine, Cedars-Sinai, Los Angeles, CA; Vice President of Clinical Innovations (Dr Braunstein), Department of Medicine, Cedars-Sinai, Los Angeles, CA; Senior Vice President, Nursing and System Chief Nursing Executive James R. Klinenberg, MD & Lynn Klinenberg-Linkin Endowed Chair in Nursing (Dr Burnes Bolton), Department of Nursing, Cedars-Sinai, Los Angeles, CA.

Published: January 2018

Objective: The aim of this article is to describe the Systems Addressing Frail Elder (SAFE) Care model, features of the interprofessional team and reengineered workflow, and details of the intervention.

Background: Older inpatients are vulnerable to adverse events related to frailty. SAFE Care, an interprofessional team-based program, was developed and evaluated in a cluster randomized controlled trial (C-RCT). Results found reduced length of stay and complications. The purpose of this article is to support and encourage the replication of this innovation or to help facilitate implementation of a similar process of organizational change.

Methods: This was a review of model features and intervention data abstracted from electronic health records.

Results: Salient features of team composition, training, and workflow are presented. The C-RCT intention-to-treat sample included 792 patients, of whom 307 received the SAFE Care huddle intervention. The most frequent problem was mobility (85.7%), and most frequent recommendation was fall precautions protocol (83.1%).

Conclusions: The SAFE Care model may provide a standardized framework to approach, assess, and address the risks of hospitalized older adults.

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http://dx.doi.org/10.1097/NNA.0000000000000564	DOI Listing

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