Change Model Overview: The ACE Star Model Of Knowledge

In 2013, a group of researchers compared the value of early discharge planning to usual care when a patient was repeatedly seen at the hospital. Based off their published work, Fox et al. (2013) made it apparent that this matter could benefit from a thorough examination to resolve hospital readmissions and length of stays for acute illnesses and injuries. A proposal to introduce early discharge planning as a consistent practice came from evidence that demonstrated a clear difference in managed care.

Change Model Overview

The ACE Star Model of Knowledge is a great design to integrate evidence-based information into practice. The goal in this model is to execute new knowledge into what is currently being practice in a great effort to improve

(2013), there are a steady number of older-aged patients with acute illnesses and injuries are returning to the hospital for avoidable visits and readmissions. This is the first step in the ACE Star Model. Historically, almost 20% of all Medicare hospital discharges were readmitted within 30 days. (McIlvennan, Eapen, and Allen, 2015) This could be caused by poor planning prior to discharge. The Medicare Payment Advisory Commission (MedPAC) predicted that 12% of readmissions could have been avoided with proper planning. Preventing at little as 10% of these readmissions could save as much as $1 billion to Medicare alone. (McIlvennan, Eapen, and Allen, 2015) This is the second step to the ACE Star

After a lengthy search performed by two reviewers, results yielded 1,736 participants that fit the characteristics of an older adult facing an acute illness or injury, admitted to one of many units, and presented with co-morbidities. In these studies, early discharge planning was done most frequently by nurses within 24- 48 hours after the patient was admitted. The interventions suggested to improve patient outcomes were outline in the details of the early discharge planning process. This included the patients functional needs being assessed to prepare for transition back home, providing education to the patient and caregiver, going over and fine-tuning medications, communicating and coordinating interventions with in-hospital healthcare providers, and following up with the patient via home visits and telephone calls after the patient has been