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Sat Feb 9, 2013, 01:35 PM

A delicate new balancing act in senior healthcare (LA Times)

Good example and overview of a more formalized team approach to in-patient / out-patient care. The goals are clear - better outcomes, a broader, less segmented approach to care and cost savings. All goals of the Affordable Care Act as noted in the article. ~ pinto

A delicate new balancing act in senior healthcare

Cedars-Sinai has launched the 'frailty project,' in which a medical team works to help at-risk elderly avoid lengthy hospital stays or readmission. The federal healthcare reform law is a driving factor.


By Anna Gorman, Los Angeles Times
February 9, 2013

When Claire Gordon arrived at Cedars-Sinai Medical Center, nurses knew she needed extra attention.

She was 96, had heart disease and a history of falls. Now she had pneumonia and the flu. A team of Cedars specialists converged on her case to ensure that a bad situation did not turn worse and that she didn't end up with a lengthy, costly hospital stay.

Frail seniors like Gordon account for a disproportionate share of healthcare expenditures because they are frequently hospitalized and often land in intensive care units or are readmitted soon after being released. Now the federal health reform law is driving sweeping changes in how hospitals treat a rapidly growing number of elderly patients.

<snip>

At Cedars-Sinai, where more than half the patients in the medical and surgical wards are 65 or older, one such effort is dubbed the "frailty project." Within 24 hours, nurses assess elderly patients for their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.

The Cedars project stands out nationally because medical professionals are working together to identify high-risk patients at the front end of their hospitalizations to prevent problems at the back end, said Herb Schultz, regional director of the U.S. Department of Health and Human Services.

http://www.latimes.com/health/la-me-frail-20130209,0,408968.story

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