Mount Sinai is rethinking healthcare as more Canadian citizens enter their retirement years. Currently, older adults represent 14.6% of Ontario’s provincial population but make up more than one third of the acute care hospital admissions and 60% of hospital days. This is largely due to the more complex, chronic health problems older adults often face and the need for more involved interventions to treat them.
As Canada’s aging population is predicted to double over the next twenty years, transformation of the traditional healthcare model has never been more important. Toronto-based Mount Sinai may have an innovative answer to the future crunch on healthcare resources. In 2010, they launched the Acute Care for Elders (ACE) initiative to support older patients following hospital discharge.
“The ACE Strategy at Mount Sinai ensures caring for older patients is maximized with an inter-professional, team-based approach, no matter where the patients are cared for,” Dr. Samir Sinha, Director of Geriatrics with Mt. Sinai and provincial lead for Ontario Senior Strategy. “Much of the collaborative work has been facilitated through the development of innovative IT communication tools, and the implementation of screening and ‘geriatricized’ care protocols that promote mobility, and the use of the most appropriate medications in older patients.”
Despite a 32% increase in older patient admissions, Mount Sinai’s ACE strategy has reduced its average total lengths of stay by 28%. Patients are also more likely to be discharged directly to home over a nursing home and less likely to be readmitted.
“What has been most impressive, were the minimal financial investments required to support this transformative model,” Sinha stated in a Hospital News report stated. “Instead it required a different approach to the way we work. Indeed, the ACE strategy has reduced our overall care costs for the older patients we serve by more than $6.4 million in 2012/2013 alone.”
Mount Sinai is the first acute care hospital in Canada to make geriatric care a core priority and the ACE program has attracted widespread attention for their pioneering work in the sector. A 2019 Harvard Business Review article has shown that Mount Sinai’s hospital-at-home program has “positive impacts on mortality rates, clinical outcomes, readmission rates and cost.”
The model is not without its challenges, of course. Pricing care and being reimbursed requires a new way of thinking about healthcare delivery. There are also barriers to ensuring that services are available to patients when they need them – providing oxygen to patients outside of regular business hours can become an issue when they are at home.
Nonetheless, Mt. Sinai highlights the possibilities for how healthcare can tackle the complex problems of providing quality care through a combination of innovative technology and creative approaches to treating patients.
“Indeed, Mount Sinai has much to be proud of but what is exciting is that its clinicians are looking to continually build on what it learns and achieves to ensure living longer and living well remains something we can achieve together,” Sinha added.