Concepts in Practice: Geriatric Emergency Departments

Authors

Lauren T. Southerland, Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH. Electronic address: lauren.southerland@osumc.edu.
Alexander X. Lo, Department of Emergency Medicine, Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL.
Kevin Biese, Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Glenn Arendts, Emergency Medicine, School of Medicine, University of Western Australia, Perth, Australia.
Jay Banerjee, College of Life Sciences, University of Leicester and Department of Emergency Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
Ula Hwang, Department of Emergency Medicine, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, NY.
Scott Dresden, Department of Emergency Medicine, Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL.
Vivian Argento, Geriatric Services, Bridgeport Hospital, Yale University School of Medicine, New Haven, CT.Follow
Maura Kennedy, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
Christina L. Shenvi, Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Christopher R. Carpenter, Department of Emergency Medicine, Washington University at St. Louis, St. Louis, MO.

Document Type

Article

Publication Title

Annals of emergency medicine

Abstract

In 2018, the American College of Emergency Physicians (ACEP) began accrediting facilities as "geriatric emergency departments" (EDs) according to adherence to the multiorganizational guidelines published in 2014. The guidelines were developed to help every ED improve its care of older adults. The geriatric ED guideline recommendations span the care continuum from out-of-hospital care, ED staffing, protocols, infrastructure, and transitions to outpatient care. Hospitals interested in making their EDs more geriatric friendly thus face the challenge of adopting, adapting, and implementing extensive guideline recommendations in a cost-effective manner and within the capabilities of their facilities and staff. Because all innovation is at heart local and must function within the constraints of local resources, different hospital systems have developed implementation processes for the geriatric ED guidelines according to their differing institutional capabilities and resources. This article describes 4 geriatric ED models of care to provide practical examples and guidance for institutions considering developing geriatric EDs: a geriatric ED-specific unit, geriatrics practitioner models, geriatric champions, and geriatric-focused observation units. The advantages and limitations of each model are compared and examples of specific institutions and their operational metrics are provided.

First Page

162

Last Page

170

DOI

10.1016/j.annemergmed.2019.08.430

Publication Date

2-1-2020

Recommended Citation

Southerland, Lauren T.; Lo, Alexander X.; Biese, Kevin; Arendts, Glenn; Banerjee, Jay; Hwang, Ula; Dresden, Scott; Argento, Vivian; Kennedy, Maura; Shenvi, Christina L.; and Carpenter, Christopher R., "Concepts in Practice: Geriatric Emergency Departments" (2020). All Research. 166.
https://scholar.bridgeporthospital.org/all_research/166

Identifier

31732374 (pubmed); NIHMS1538228 (mid); PMC6980991 (pmc); 10.1016/j.annemergmed.2019.08.430 (doi); S0196-0644(19)31114-X (pii)