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Research finds transitional care unit can reduce ALC and hospital stays


A new case-control study has been published in JAMDA on the effectiveness of an innovative pilot program designed to address capacity and overcrowding challenges in Ontario hospitals. The study evaluated the performance of a transitional care program called the SAFE (Sub-Acute Care for Frail Elderly) Unit, which offers function-focused care to eligible acute-care hospital patients.


The program targeted frail patients who likely would be been designated to alternate level of care (ALC) and were at risk of deconditioning during their stay, and found that despite having more complex disease profiles, SAFE Unit patients spent less time in hospital than ALC patients.


Amy Hsu, PhD and investigator at the Bruyère Research Institute and ICES, teamed up with the Perley and Rideau Veterans’ Health Centre to analyze the impacts of the SAFE Unit.


Compared to ALC patients in local hospitals, frail elderly patients who received care in the SAFE Unit:


  • Experienced 18% fewer days in hospital
  • Were 38% more likely to be discharged home, as opposed to other care settings
  • Were 3X less likely to require home or community care
  • Were no more likely to require an emergency room visit 30-days after discharge

Transitional care units, such as the SAFE and Bruyère’s new 21-bed unit, especially when supplemented by access to medical and restorative care, are innovative models that are proving to contribute to increased independence of patients and decreased length of stay in hospital.


This study is an example of the type of evaluation needed when working towards building a sustainable health system that improves the care experience for older Ontarians.

Read the full article: A Case-Control Study of the Sub-Acute care for Frail Elderly (SAFE) Unit on Hospital Readmission, Emergency Department Visits and Continuity of Post-discharge Care

The SAFE Unit is a 20-bed program located at the Perley and Rideau Veterans’ Health Centre in Ottawa. This research was funded by Ontario’s Ministry of Health and Long-term Care.

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