Concepts in Practice: Geriatric Emergency Departments

Area of Science:

• Geriatric Emergency Medicine
• Healthcare Quality Improvement
• Hospital Administration

Background:

• The American College of Emergency Physicians (ACEP) initiated geriatric emergency department (ED) accreditation in 2018.
• Accreditation is based on multiorganizational guidelines established in 2014 to enhance care for older adults in EDs.
• These guidelines cover the entire care continuum, including pre-hospital, staffing, protocols, infrastructure, and post-discharge transitions.

Purpose of the Study:

• To provide practical examples and guidance for hospitals seeking to implement geriatric ED guidelines.
• To address the challenge of adopting and adapting extensive guidelines cost-effectively within varying institutional constraints.
• To present four distinct models of care for geriatric emergency departments.

Main Methods:

• Description of four geriatric ED models: dedicated unit, practitioner models, champion programs, and observation units.
• Comparison of the advantages and limitations of each implemented model.
• Inclusion of specific institutional examples and their operational metrics.

Main Results:

• Different hospital systems have developed unique implementation processes tailored to their resources and capabilities.
• The article details four distinct approaches to establishing geriatric-friendly EDs.
• Operational metrics and comparative analyses are provided for each model.

Conclusions:

• Successful implementation of geriatric ED guidelines requires adaptation to local resources and institutional capacity.
• The presented models offer practical frameworks for developing geriatric emergency departments.
• Guidance is provided for institutions aiming to improve emergency care for older populations.