Transforming Emergency Care For Older Adults

TLDR

US emergency departments are overcrowded and stressful, struggling to serve an aging population that requires complex, lengthy evaluations. The study seeks creative solutions to improve the value and quality of emergency care for older adults by addressing their complex physical, social, cognitive, and situational needs. The authors develop geriatric emergency care models—some already used in dedicated geriatric EDs—that incorporate physical, procedural, and staffing changes, and explore options such as telemedicine, observation units, and comprehensive discharge planning to reduce ED visits, hospitalizations, and rehospitalizations. Transforming EDs into care‑coordination partners can improve integration into the health system, enhance patient outcomes, optimize care delivery, and lower overall costs, benefiting patients of all ages.

Abstract

Already crowded and stressful, US emergency departments (EDs) are facing the challenge of serving an aging population that requires complex and lengthy evaluations. Creative solutions are necessary to improve the value and ensure the quality of emergency care delivered to older adults while more fully addressing their complex underlying physical, social, cognitive, and situational needs. Developing models of geriatric emergency care, including some that are already in use at dedicated geriatric EDs, incorporate a variety of physical, procedural, and staffing changes. Among the options for "geriatricizing" emergency care are approaches that may eliminate the need for an ED visit, such as telemedicine; for initial hospitalization, such as patient observation units; and for rehospitalization, such as comprehensive discharge planning. By transforming their current safety-net role to becoming a partner in care coordination, EDs have the opportunity to become better integrated into the broader health care system, improve patient health outcomes, contribute to optimizing the health care system, and reduce overall costs of care—keys to improving emergency care for patients of all ages.