MACE Service Model Improves Outcomes for Hospitalized Older Adults

​Older adults admitted to the Mobile Acute Care of the Elderly (MACE) service experienced lower rates of adverse events, shorter hospital stays, and higher patient satisfaction compared with usual care, according to the results of a study published online April 22, 2013, in JAMA Internal Medicine. The MACE interdisciplinary team, which consisted of an attending geriatrician-hospitalist, a geriatric medicine fellow, a social worker, and a clinical nurse specialist, met daily to discuss the care of all patients, and the nurse specialist acted as the “hospital coach,” educating the patient or the caregiver when necessary. The MACE service also included elements to improve care transitions, such as medication reconciliation before discharge and communication with the primary care physician within 24 hours of discharge. The usual-care team included an internal medicine attending physician, not a geriatrician, and did not have a clinical nurse specialist. In addition, the usual care team included a unit-based social worker rather than a team-based social worker. All other aspects of care for the two patient groups were similar. The data indicated that among patients in the MACE group, 15.4% were readmitted within 30 days of discharge compared with 22.4% in the usual-care group.