An innovative approach to geriatric acute care delivery: the Choate-Symmes experience.

Hospitals, like those described in this study, must develop alternative models of health care delivery that allow them to respond to many challenges while providing high-quality health care to geriatric patients. In this program, 10-bed geriatric units were established in two hospitals, and patients age 65 and older were selected at random for admission to the units. Following comprehensive assessment, self-reliance was fostered using individualized interventions. Discharge planning began at admission. A multidisciplinary approach with regular team conferences including families was also used. Results of this approach suggest that such intervention can reduce length of stay without affecting quality of care. This paper describes the delivery model in detail, focuses on issues related to the implementation of the intervention, and highlights the lessons learned by Choate-Symmes personnel through their demonstration of the model.