Medical Units

Medical Telemetry Unit (28 beds): West Region Teaching hospital (600+ beds)

Time Period: 12 months pre- vs 9 months post-implementation

Outcomes

  • In-hospital mortality: 23% reduction
  • Complications of care: 25% reduction
  • Length of stay: 13% reduction
  • 30-day readmissions: 30% reduction
  • Average total cost per case: $583 reduction

The medical director explained what the ACU™ care model has meant for the unit.

Team-based care: “The approach has brought team-based care to the hospital and collegiality and empathy among staff. Doctors had no idea of what other members of the care team did before the model was introduced. Today, everyone knows everyone by their first names. There is much more communication.”

Integrating ACUs with teaching programs: “We’ve been teaching the same way for 50 years. With ACUs, we teach delivery of care. That’s where things are heading, and residents need to understand that prescribing a medicine is the easy part. The hard part is getting a huge, complicated system to deliver the prescription to the patient’s mouth. The ACU model helps with that.”

__________

Medical Telemetry Unit (24 beds): Southeast Region Teaching hospital (550+ beds)

Time Period: 12 months pre- vs 12 months post-implementation

Outcomes

  • Mortality : 53.1% reduction (1.1 vs. 2.3 deaths per 100 encounters (p = 0.004))
  • Referrals to Hospice: 18.0% reduction (4.5 vs. 5.4 per 100 encounters (p = 0.17))
  • Length of Stay: 11.1% reduction (4.5 vs. 5.0 days (p=0.001))

The medical director credited the ACU™ care model with generating time efficiency gains for physicians: “Physicians initially believed an extra hour in the morning to round with the team was something they could not afford. But once physicians began practicing in this model, they found that hour to be the most important of their day, setting them up to be much more time-efficient with finding greater control and influence over the priorities and activities of the entire care team.”

__________

Medical Unit (30 beds): Southeast Region Community Hospital (600+ bed)

Time Period: 12 months pre- vs 8 months post-implementation

This facility, recognized as one of nations Top 100 Hospitals by Thompson Reuters, reduced length of stay and readmissions while creating tremendous gains in teamwork and clinician satisfaction. Some of the impressive outcomes included:

  • Length of stay: 16% reduction (4.1 vs 4.9 days pre-ACU)
  • 30-day readmission rate: 25% reduction
  • Improved Teamwork: Nurses ratings of “Very good or Excellent” post-ACU implementation:
    • Teamwork with physicians – 100% (vs 65% pre-ACU implementation)
    • Physicians speaks face-to-face with me daily – 100% (vs 9% pre-ACU implementation)
    • Physicians really listen to me and value my input – 92% (vs 65% pre-ACU implementation)
  • Improved Teamwork: Physician ratings of “Very good or Excellent” post-ACU implementation:
    • Nurses prepared to discuss patient – 100% (vs 65% pre-ACU implementation)

Geriatric Care Units

Geriatric Care Unit (10 beds): Midwest Region Teaching Hospital (500+ beds)

Time Period: 8 months post-implementation

Outcomes

Implementing the ACU™ care model helped create a culture of safety resulting in a unit virtually free of falls, venous thromboembolisms, and pressure ulcers.” Outcomes included:

  • Falls: 157 consecutive days without a fall (>2x length of previous no-falls record)
  • Length of stay: 13% reduction
  • Readmission rate (age >70 discharged home): 4.3% (vs 12.5% hospital-wide)
  • Readmission rate (age >70 discharged to nursing home): 6.3% (vs 13.5% hospital-wide)

The medical director leading implementation observed that the ACU care model “helped establish a culture of safety,” describing the unit as a place “where people don’t fall, where people don’t die.”

__________

Geriatric Care Unit (30 beds): Southeast Region Community Hospital (450+ beds)

Time Period: 4 months post-implementation

Outcomes

  • Nursing turnover: 64% reduction (1 vs 2.8 losses per month)

The medical director credited the ACU™ care model with improving professional satisfaction for nurses: “Implementing an ACU has had a profoundly positive impact on nursing satisfaction at our hospital. I can confidently say I would now refer my family members to this unit. The pilot unit has become a gold-standard demonstration unit to support the launch of other units in our health system.”


Cardiology Units

Cardiology Unit (30 beds): Northeast Region Teaching Hospital (700+ beds)

Time Period: 15 months pre- vs 15 months post-implementation

Outcomes

  • Code Blue calls: 40% reduction (0.9 vs 1.5 per month)
  • Length of stay: 9% reduction