Online LACE Index Tool
The LACE index is a validated risk assessment tool, which is used to prospectively identify patients who might benefit from more intense post-discharge care.  A composite risk score is generated, based upon 4 key inputs:
  • L:  Length of stay
  • A:  Acuity of admission
  • C:  Charlson comobidity index
  • E:  Number of Emergency Department Visions in the last 6 months (van Walraven et al., 2010).
A web-based version of the LACE index tool has been developed by HSPRN researchers at the University of Waterloo. Based on information input by a clinician, the tool will generate a LACE index score for an individual patient.  It will also provide the expected risk of readmission for an individual a recommendation as to the appropriateness of a care transition intervention.  Care transition interventions provide integrated follow-up care in the community after an at-risk patient has been discharged from hospital. Evidence suggests that care transition interventions can be effective to reduce readmissions to hospital (Naylor et al. 2011, Coleman et al. 2006).  

References

Baker GR et al., Enhancing the Continuum of Care - Report of the Avoidable Hospitalization Advisory Panel. November 2011. Queen’s Printer for Ontario

Coleman EA et al. (2006) “The Care Transitions Intervention: Results of A Randomized Control Trial” Archives of Internal Medicine 166:1822-1828

Hansen LO, Young RS, Hinami K, Leung A, Williams MV. (2011) Interventions to reduce 30-day rehospitalization: a systematic review. Ann Intern Med. 155(8):520-8. 

Naylor MD, Aiken LH, Kurtzman ET, Olds DM, Hirschman KB. (2011) The Importance Of Transitional Care In Achieving Health Reform.  Health Affairs 30(4): 746-754.

van Walraven C, Dhalla IA, Bell C, Etchells E, Stiell IG, Zarnke K, Austin PC, Forster AJ. (2010). Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Canadian Medical Association Journal 182(6): 551-557.