1001 – The Geriatric ED Patient: A Collaborative Approach to Safe Transitions of Care Across the Continuum
The emergency department (ED) serves as a primary entry point into our health system for many elderly patients. The care and management of the geriatric patient within the ED can be complex and time consuming as they often present with multiple comorbidities, poly-pharmacy and a decline in function. This becomes challenging when an older adult presents to the emergency department who doesn’t meet admission criteria but isn’t safe to return home. What now?
Historically, this type of a patient would be a “social” admission placing the patient at risk for an increase in mortality, poorer clinical outcomes, delirium and a potential increase in functional decline. Meeting the needs of this complex patient population has resulted in a need to shift the focus on emergency care to early identification of the high risk geriatric patient along with an immediate consultation of an ED based multidisciplinary team prepared to meet these needs.
Although the process of transitioning a patient directly from the ED is driven by the case manager, a safe transition requires a team approach. This multidisciplinary team can include but is not limited to nursing case management, social work, pharmacy, geriatrics, respiratory therapy, physical and/or occupational therapy, and the ED nursing and medical staff. Once consulted, each team member provides for a timely assessment with recommendations for a safe transition of care with the goal of providing for the right care, at the right time, in the right place.
The addition of this ED based team has many favorable outcomes to include an increase in the sharing of information and collaboration with the community based care providers resulting in better clinical outcomes, safer transitions of care, increased patient safety and satisfaction, as well as a decrease in inappropriate admissions and use of acute care beds.
1. Identifies factors that place the elderly patient at risk during a visit to the emergency department
2. Describes the roles and functions of the emergency department team members in the collaboration and development of safe transitions of care for the elderly
3.Demonstrate through the sharing of case studies the impact of safe transitions of care across the continuum on improved clinical outcomes and patient/family satisfaction