New U-M program helps patients transition to treatment at sub-acute care centers

U-M Geriatrics Center program improves care, shortens hospital stays

ANN ARBOR, MI – A new program launched by the University of Michigan Geriatrics Center is helping patients transition from the hospital into skilled care settings quicker and with fewer complications than before. The unique program provides seamless, high-level care through hospital discharge to less intensive—or sub-acute—care facilities. The results are shorter hospital stays with fewer return hospitalizations during recovery.

The U-M Health System’s Sub-Acute Care Program provides continuity of care for patients who no longer require hospitalization, but who still need skilled medical care in a transitional setting. U-M physicians and nurses follow patients after discharge to provide care on-site in one of three area facilities currently partnering in the program.

“This program bridges the gap that often exists between discharge from the hospital and entering a sub-acute care facility,” notes Jeffrey Halter, M.D., director of the U-M Geriatrics Center and chief of the U-M Division of Geriatric Medicine. “Now, patients can leave the hospital and begin rehabilitation sooner, because they continue to receive the same expert care from U-M geriatric physicians and nurses during the transition.”

U-M geriatric physician Darius K. Joshi, M.D., is director of the Sub-Acute Care Program and medical director of the Heartland Health Care Centers of Ann Arbor and Canton. The program has been implemented at the two Heartland sites and at Glacier Hills Skilled Nursing Center in Ann Arbor.

“Our patients are frail enough to require extra care, but they do not need to be in a hospital to receive that care,” Joshi says. “In many instances, a hospital is not the best place for older adults. They are exposed to more sick people and hospital-borne illnesses, and it may not be easy for their families to visit them for long periods of time in the hospital.”

The Sub-Acute Care Program was built on a model of care at Glacier Hills, which has been affiliated with the U-M Geriatrics Center for many years. Now, the level of care has been enhanced with this program, using U-M information technology.

At the Heartland and Glacier Hills facilities, physicians and nurse practitioners have access to patient medical records using U-M’s CareWeb electronic medical records system. The care providers can input directly into the system, and they can view a patient’s history of diagnoses and treatments. Access to a single medical record from both facilities enhances care for patients at the sub-acute care centers and when they return to a U-M clinic or the Emergency Department.

“Our goal is to hasten the transition from the hospital and improve care at the same time,” says Rick Bluhm, U-M Geriatrics Center administrator and a creator of the Sub-Acute Care Program. He notes that the program has reduced hospital stays for patients by two to three days, on average. “If shorter hospital stays can translate into quicker recoveries in sub-acute care centers, we consider it a success.”

Those involved with the program also hope it will help to shed light on the fact that sub-acute care centers are very different from what people may envision.

“There is still a popular misconception about facilities such as these, with some people still thinking of them as nursing homes where people live out their final days and years,” says Caroline Blaum, M.D., associate professor in the Division of Geriatric Medicine at U-M, research scientist at the Veterans Affairs Ann Arbor Healthcare System and one of the creators of the program. “In reality, sub-acute care centers have become a place where many people stay for short periods of time, and they are an integral part of the treatment of older adults.”

The University of Michigan Geriatrics Center is a premier, national resource dedicated to providing outstanding educational opportunities, advanced research on aging and related healthcare issues, and exemplary multi- and interdisciplinary care and services for the older population. These activities are conducted with the prevailing mission to increase the span of healthy, active life for older adults.

Written by: Katie Gazella