{"id":1469,"date":"2018-01-11T14:48:39","date_gmt":"2018-01-11T19:48:39","guid":{"rendered":"http:\/\/www.healthinaging.org\/blog\/?p=1469"},"modified":"2018-01-11T14:48:39","modified_gmt":"2018-01-11T19:48:39","slug":"older-adult-friendly-emergency-department-staff-help-reduce-hospital-admissions","status":"publish","type":"post","link":"https:\/\/www.healthinaging.org\/blog\/older-adult-friendly-emergency-department-staff-help-reduce-hospital-admissions\/","title":{"rendered":"Older Adult-Friendly Emergency Department Staff Help Reduce Hospital Admissions"},"content":{"rendered":"<p><strong><em><a href=\"https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic.jpg\"><img loading=\"lazy\" class=\"alignleft size-thumbnail wp-image-1223\" src=\"https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic-150x150.jpg\" alt=\"JAGS graphic\" width=\"150\" height=\"150\" srcset=\"https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic-150x150.jpg 150w, https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic-300x300.jpg 300w, https:\/\/www.healthinaging.org\/blog\/wp-content\/uploads\/2017\/05\/JAGS-graphic.jpg 350w\" sizes=\"(max-width: 150px) 100vw, 150px\" \/><\/a><span style=\"color: #800080;\">Journal of the American Geriatrics Society<\/span><\/em><span style=\"color: #800080;\">\u00a0Research Summary<\/span><\/strong><\/p>\n<p>When older adults arrive at a hospital\u2019s <a href=\"http:\/\/www.healthinaging.org\/files\/documents\/tipsheets\/GeriatricsED_May2014.pdf\">emergency department (ED)<\/a>, they may face unexpected challenges. For example, they may become less able to function independently. They may develop difficulties thinking and making decisions during or following a visit to the ED. This makes transitions in care to and from the ED an important area for improvement in our health care as we age.<\/p>\n<p>To address these challenges, geriatrics experts have developed special programs such as the \u201cGeriatric Emergency Department Innovations in Care through Workforce, Informatics, and Structural Enhancements\u201d (GEDI WISE) program. GEDI WISE is an award-winning program that serves as a model for excellence in emergency care for older adults in three large urban hospitals: Mount Sinai Medical Center in New York, NY; St. Joseph\u2019s Regional Medical Center in Paterson, NJ, and Northwestern Memorial Hospital in Chicago, IL.<\/p>\n<p>One piece of the GEDI WISE program includes an ED-based geriatrics transition care nurse (TCN). The TCN identifies patients who have health needs specific to older adults. This nurse works to help people transition to their homes so that they can avoid hospital admission whenever possible.<\/p>\n<p>A team of researchers designed a study to learn how effective the GEDI WISE TCNs were for reducing hospital admissions, later admissions, and revisits to the ED. They published their findings in the <em>Journal of the American Geriatrics Society<\/em>.<\/p>\n<p>The study took place in 2013-2015 in all three hospitals in the GEDI WISE program. They studied more than 57,000 people aged 65 or older who made more than 120,000 visits to the three participating hospitals\u2019 EDs.<\/p>\n<p>The TCN nurses gave the older adults several different screenings, including tests for:<\/p>\n<ul>\n<li>Cognition<\/li>\n<li><a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:delirium\/\">Delirium<\/a><\/li>\n<li>Functional status<\/li>\n<li>Falls risk<\/li>\n<li><a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:caregiver-health\/\">Caregiver strain<\/a><\/li>\n<li>Care transitions<\/li>\n<\/ul>\n<p>Informed by these screenings, the TCN used various <a href=\"http:\/\/www.healthinaging.org\/aging-and-health-a-to-z\/topic:geriatrics\/\">geriatrics<\/a> resources to help patients. Some people required only a little support, while others needed extensive help.<\/p>\n<p>Older adults who saw the TCN at least once during the study period were included in the \u201cintervention group.\u201d Older adults who didn\u2019t see the TCN during the study period were included in the \u201ccontrol group.\u201d<\/p>\n<p>Compared to the control group, people who saw the TCN had lower rates of inpatient (hospital or healthcare facility) admissions over 30 days at two of the three hospitals.<\/p>\n<p>The researchers concluded that programs focusing on improving care transitions for older people seen in the ED may help reduce the risk for hospital admission.<\/p>\n<p><strong>This summary is from <\/strong><a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgs.15235\/full\"><strong>\u201cGeriatric Emergency Department (ED) Innovations: ED transitional care nurses &amp; hospital utilization.\u201d<\/strong><\/a><strong> It appears online ahead of print in the <em>Journal of the American Geriatrics Society<\/em>. The study authors are Ula Hwang, MD, MPH; Scott M. Dresden, MD; Mark S. Rosenberg, DO, MBA; Melissa M. Garrido, PhD; George Loo, DrPh; Jeremy Sze, BS; Stephanie Gravenor, MBA; D. Mark Courtney, MD; Raymond Kang, MA; Carolyn Zhu, PhD; Carmen Vargas-Torres, MS; Corita R. Grudzen, MD, MSHS; Lynne D. Richardson, MD; and the GEDI WISE Investigators.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Journal of the American Geriatrics Society\u00a0Research Summary When older adults arrive at a hospital\u2019s emergency department (ED), they may face unexpected challenges. For example, they may become less able to function independently. They may develop difficulties thinking and making decisions &hellip; <a href=\"https:\/\/www.healthinaging.org\/blog\/older-adult-friendly-emergency-department-staff-help-reduce-hospital-admissions\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[4,91,9],"tags":[16,158,157,159],"_links":{"self":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts\/1469"}],"collection":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/comments?post=1469"}],"version-history":[{"count":1,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts\/1469\/revisions"}],"predecessor-version":[{"id":1470,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/posts\/1469\/revisions\/1470"}],"wp:attachment":[{"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/media?parent=1469"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/categories?post=1469"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthinaging.org\/blog\/wp-json\/wp\/v2\/tags?post=1469"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}