A hospital emergency department can be a chaotic and dangerous place for older adults, resulting in poor outcomes, distress, and dissatisfaction for them and their families.
We’ve had several posts on Health AGEnda related to emergency department (ED) care of older adults (See Building a Better Emergency Department for Older People, Collaboration Across Departments and Foundations Leads to Improved Emergency Care , and Can EMTs Improve Outcomes for Older Adults Leaving ER?). Older people use emergency rooms in greater numbers than younger adults, and once admitted are more likely to have an emergent or urgent condition, be hospitalized, and be admitted to a critical care unit.
Fortunately, there’s a growing cadre of passionate emergency medicine physicians with geriatrics expertise who are trying to improve emergency care for older people. This is happening in part through the American Geriatrics Society’s Geriatrics for Specialists Initiative and the Jahnigen Scholars program, which we’ve funded for years. The Atlantic Philanthropies and others have supported the Jahnigen Scholars as well as work in specialty nursing care, reaching out to emergency nurses to build their geriatrics expertise.
And now, a movement has begun in the emergency care world to create “geriatric emergency departments.” The idea is a good one: Re-imagine the emergency department from the point of view of an older adult and redesign the physical environment, train staff in geriatrics principles, and implement geriatric care models that will improve health outcomes, reduce costs to the health system, and improve the experience of care for these patients.
Having a “geriatric emergency department” can also be highly beneficial to a hospital trying to market itself to the growing number of older people in its community. This has led some in the field to question whether geriatric EDs are really changing care or simply using a marketing ploy.
Click on image for copy of the Geriatric Emergency Department Guidelines.To help ensure that high-quality care is delivered in these emerging geriatric EDs, geriatrics champions in emergency care came together to develop Geriatric Emergency Department Guidelines. These guidelines, which present recommendations on staffing, discharge follow-up, education, and policies/protocols, represent the product of two years of consensus-based work that included representatives from the American College of Emergency Physicians, the American Geriatrics Society, Emergency Nurses Association, and the Society for Academic Emergency Medicine. The boards of directors for each of these organizations have officially adopted these guidelines and are now seeking to make them broadly known and implemented.
We are pleased to share these guidelines and ask that you do the same if your hospital system has or will be considering implementing a geriatric ED.
Of course, the other important goal is to make sure that all EDs—whether they call themselves “geriatric” or not—deliver the right kind of care to older adults. These guidelines can help all emergency departments by highlighting what best practice in the ED should look like.