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ACE Model for Older Adults in ED.

Martine Sanon1, Ula Hwang2,3, Gallane Abraham4

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A Geriatric Emergency Department (GED) utilized an interdisciplinary team (IDT) to provide comprehensive care for older adults. This model improved care for vulnerable seniors presenting to the emergency department (ED).

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ACE modelIDTgeriatric emergency caretransitional care

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Area of Science:

  • Geriatric Medicine
  • Emergency Medicine
  • Health Services Research

Background:

  • Emergency departments (EDs) are critical for improving care for older adults.
  • The Mount Sinai Hospital ED serves over 15,000 older adults annually.
  • A dedicated Geriatric Emergency Department (GED) implemented an Acute Care for Elderly (ACE) model.

Purpose of the Study:

  • To describe the role of a Geriatric Emergency Medicine interdisciplinary team (IDT) in an innovative ACE model.
  • To outline the impact of comprehensive geriatric assessments and IDT interventions for high-risk older adults in the ED.

Main Methods:

  • Replicated an ACE model in a dedicated GED from 2012-2015.
  • Utilized the Identification of Seniors at Risk (ISAR) screen for patient identification.
  • Conducted daily IDT meetings with diverse specialists for high-risk patients.

Main Results:

  • The IDT, including physicians, nurses, social workers, pharmacists, and therapists, developed care plans for vulnerable elders.
  • Approximately 30% of evaluated patients were formally discussed in IDT rounds.
  • IDT input influenced decisions on hospital admission, care transitions, community resources, and medication management.

Conclusions:

  • The Geriatric Emergency Medicine IDT serves as an innovative ACE model for older adults in the ED.
  • This interdisciplinary approach enhances the care and outcomes for vulnerable seniors.
  • Comprehensive geriatric assessments and coordinated care planning are vital in the emergency setting.