Impact of an Accountable Care Unit on mortality

Laura Loertscher, Lian Wang and Shelley Schoepflin Sanders

Overview

The implementation of the Accountable Care Unit (ACU) care model and Structured Interdisciplinary Bedside Rounds (SIBR) significantly improved length of stay, patient experience and discharge efficiency. 

0 hour
reduction in LOS

Objectives

To improve patient and care team satisfaction and efficiency by improving communication between the inpatient care team, patients and their families through implementation of the ACU and SIBR rounds. 

Methods

Patients on a 36-bed unit were divided between two hospitalist physicians. Each patient was reviewed comprehensively by all disciplines to assess additional needs or interventions, with rounds conducted by a provider, coordinator, and bedside nurse at the bedside using a structured communication protocol. 

Results

Patient Experience (HCAHPS)

• Likelihood to Recommend (LTR) improved from the 61st to the 91st percentile.

• Patient perception of physician communication improved from the 2nd to the 90th percentile.

Length of Stay and Efficiency

• Length of Stay (LOS) reduced by 12 hours.

• Discharge planning efficiency improved from 60 to 25 minutes per day for all patients.

Conclusion

The interdisciplinary collaboration model led to improved efficiency and patient experience metrics. The success of the pilot has generated enthusiasm to scale the ACU model across all medical-surgical units at Utah Valley Hospital. Future steps include transitioning to geographic rounding and ensuring hospitalist group buy-in. The impact on provider satisfaction will be studied moving forward.

Additional Data

Patient HCAHPS scores significantly improved for the unit. 

I hope you enjoyed reading these strong results. Unit outcomes like these are achievable within 3 to 6 months using a seasoned implementation methodology:

  1. skillful project management
  2. smooth training and launch, and a
  3. long-term partnership for sustainability.

One option to achieve similar results is to engage our 1Unit experts. Backed by 15 studies like this one, our work has received awards from The Joint Commission, CMS, Clinical Excellence Commission, IHI, BMJ, and the Society of Hospital Medicine.

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Liam Chadwick, PhD