Systems Addressing Frail Elder Care: Description of a Successful Model

J Nurs Adm. 2018 Jan;48(1):11-17. doi: 10.1097/NNA.0000000000000564.

Abstract

Objective: The aim of this article is to describe the Systems Addressing Frail Elder (SAFE) Care model, features of the interprofessional team and reengineered workflow, and details of the intervention.

Background: Older inpatients are vulnerable to adverse events related to frailty. SAFE Care, an interprofessional team-based program, was developed and evaluated in a cluster randomized controlled trial (C-RCT). Results found reduced length of stay and complications. The purpose of this article is to support and encourage the replication of this innovation or to help facilitate implementation of a similar process of organizational change.

Methods: This was a review of model features and intervention data abstracted from electronic health records.

Results: Salient features of team composition, training, and workflow are presented. The C-RCT intention-to-treat sample included 792 patients, of whom 307 received the SAFE Care huddle intervention. The most frequent problem was mobility (85.7%), and most frequent recommendation was fall precautions protocol (83.1%).

Conclusions: The SAFE Care model may provide a standardized framework to approach, assess, and address the risks of hospitalized older adults.

Publication types

  • Review

MeSH terms

  • Accidental Falls / prevention & control*
  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Female
  • Frail Elderly*
  • Geriatric Nursing / organization & administration*
  • Health Services for the Aged / organization & administration*
  • Humans
  • Interprofessional Relations
  • Male
  • Middle Aged
  • Models, Nursing
  • Nursing Staff, Hospital / psychology*
  • Organizational Innovation*
  • Patient Care Team / organization & administration*
  • United States