استعرض مصدر Geriatric Emergency Department Initiative (GEDI) Team: An Innovative Force in Emergency Care


S96 AGS 2016 Annual Meeting

B31

Geriatric Emergency Department Initiative (GEDI) Team: An
Innovative Force in Emergency Care

D. Dobschuetz. Emergency Medicine, Northwestern University,
Chicago, IL.

Supported By: none
Body

There is an exponentially growing need to provide senior sensitive
care in t emergency departments (ED). On a national level, patients
65 years and older comprise an ever increasing percentage of all
hospital admissions from the ED. Over the last three years, in an urban
University Hospital emergency department, a GEDI Team of specially
trained nurses in geriatric assessments has had a profound impact.
Admissions have been avoided, Length of Stays (LOS) has decreased,
patients have transitioned safely, and staff attitudes have improved.
These measures are the keystones of an initiative to address the needs
of seniors admitted to the ED in a systematic and evidence-based way.

Method

Four ED nurses were trained to use 6 specific geriatric assessment
tools and act as “geriatric liaisons” as part of the GEDI Team.
The entire staff was trained to identify seniors that needed a referral
to the “liaisons.” All of the assessment tools were imbedded templates
in the electronic medical record. An objective staff survey was used
to identify perception, care, and knowledge of ED personnel over a
period of 3 years and then compared to national norms.

Results

Prior to the program implementation approximately 60% of the
geriatric patients being seen annually at the ED were either full admission
or observational status. During the first year there was a 16% drop
in the geriatric population admission rate (44% - 25% full admission
and 19% observational). This reduced rate has remained consistent
over the entire course of the program. Approximately 5% of the geriatric
population admitted to the ED receives referrals to the GEDI
Team and/or complementary social work and physical therapy. The
results show in comparison to control groups that the referred patients
have higher rates of discharge (50% vs. 30%), lower admission rates
from the ED (28% vs. 48%), and patients admitted to in-patient or
observation, had shorter hospital LOS (88 vs.104 hours). The staff
survey showed a significant improvement in attitudes, perceptions and
care actions. These successful outcomes resulted in continued program
funding by the hospital after grant completion.

Conclusions

GEDI Team program has implications for lowering unnecessary
admissions, shorter lengths of stay, safer transitions, and improved
staff attitude, perceptions and care actions. This program, because
of its easy adaptability, has implications for successful replication in
other EDs.

http://onlinelibrary.wiley.com.ezp.uod.edu.sa/doi/10.1111/jgs.14231/pdf

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[[تصنيف:تصنيف:Geriatric Core Competencies]]