{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:19:54Z","timestamp":1793974794401,"version":"4.8.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000886","name":"Duke Endowment","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000886","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acute Care for Elders (ACE) units reduce hospital\u2010associated delirium, functional decline, and lengths of stay. However, establishing and sustaining such units have proven difficult. There are only 43 ACE units among the &gt;3500 hospitals in the United States. This study describes an iterative quality improvement process, which allowed us to establish and sustain an ACE unit care model in a modern academic hospital. This continuous process was centered on implementing the key principles of the ACE unit model of care: patient\u2010centered care assessments, medical care review, specialized prepared environment, early mobilization, physical therapy, and early planning for discharge to home. Quality of care and patient outcomes data for older adults admitted to our ACE unit includes mortality index (observed\/expected) consistently &lt;1 (FY22\u2009=\u20090.86), 30\u2010day readmission rate of &lt;10% (FY22 9.31%), and length of stay index of ~1 (FY22 1.07). We describe how work on our ACE unit has led to hospital\u2010wide initiatives, including dementia\u2010friendly hospital certification. Our hope is that others can use this process to enhance the dissemination of the ACE unit model of care.<\/jats:p>","DOI":"10.1111\/jgs.18561","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T09:30:27Z","timestamp":1692783027000},"page":"3031-3039","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Establishing and sustaining an acute care for elders unit: An incremental journey to success"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-9367","authenticated-orcid":false,"given":"David H.","family":"Lynch","sequence":"first","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Mournighan","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Dale","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4027-4113","authenticated-orcid":false,"given":"Hillary B.","family":"Spangler","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gotelli","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Davis","sequence":"additional","affiliation":[{"name":"University of North Carolina Hospital at Chapel Hill University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittra","family":"Felton","sequence":"additional","affiliation":[{"name":"University of North Carolina Hospital at Chapel Hill University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Lingley\u2010Brown","sequence":"additional","affiliation":[{"name":"University of North Carolina Hospital at Chapel Hill University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Busby\u2010Whitehead","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-4416","authenticated-orcid":false,"given":"John A.","family":"Batsis","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Department of Nutrition, Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Hanson","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Center for Aging and Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Cecil G. Sheps Center for Health Services Research University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199505183322006"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/AGEING\/AFAC081"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.12028"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.12282"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.17892"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/23337214221109005"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/GERIATRICS3030059"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462303000205"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/GERIATRICS3030058"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AMJMED.2008.04.018"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0B013E3182A5A045"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1532\u20105415.2009.02621.X"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006211.PUB3"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.HJDSI.2017.05.005"},{"key":"e_1_2_12_16_1","unstructured":"Fulmer: Age\u2010friendly health systems: A guide to using\u2026\u2014Google Scholar. Accessed April 30 2023.https:\/\/scholar.google.com\/scholar_lookup?hl=en&publication_year=2022&pages=%00empty%00&author=T+Fulmer&isbn=%00null%00&title=Age%E2%80%90Friendly+Health+Systems%3A+A+Guide+to+Using+the+4Ms+while+Caring+for+Older+Adults"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.15473"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.17994"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.15237"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13095"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16699"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2018.06.007"},{"key":"e_1_2_12_23_1","volume-title":"Dementia Friendly Hospital Initiative","year":"2018"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.18561","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:29:47Z","timestamp":1762176587000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.18561"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,23]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/jgs.18561"],"URL":"https:\/\/doi.org\/10.1111\/jgs.18561","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,23]]},"assertion":[{"value":"2023-05-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}