2.50
Hdl Handle:
http://hdl.handle.net/10755/324171
Category:
Abstract
Type:
Presentation
Title:
GEDI WISE: Bridging the Gap from the ED to Home
Author(s):
Buckley, Barbara A.; O'Connell Burke, Erin; Dobschuetz, Dwayne; Salgado, Alicia; GEDI WISE Author Group
Author Details:
Barbara A. Buckley, BSN, RN, email: bbuckley@nmh.org; Erin O'Connell Burke, BSN, RN; Dwayne Dobschuetz, MSN, RN; Alicia Salgado, BSN, RN; GEDI WISE Author Group
Abstract:
Evidence-based Practice Abstract Purpose: The number of Americans aged 65 or older will increase 36% from 40 million to 54.6 million by 2020. Heath care institutions must develop strategies to address the needs of this unique population. The Emergency Department is situated at the junction of outpatient and inpatient care and can be an effective facilitator in improving outcomes. The objective of this study is to implement a targeted intervention by a multidisciplinary team of clinicians to improve the health and quality of care of geriatric patients in the Emergency Department. Led by an innovative new clinician, the geriatric nurse liaison, the project aims to facilitate transition from the Emergency Department to the outpatient setting and reduce hospital admissions and readmissions. Design: This is a quality improvement project focusing on care coordination and geriatric assessment of Emergency Department patients. Setting: The overall project is a three-site collaboration. The present report describes the design at one site, an urban, academic Emergency Department with an annual volume of 85,000 visits per year, 18% of which are geriatric. Participants/Subjects: Patients 65 and older who arrived to the Emergency Department between the hours of 8am-6pm M-F, with an Identification of Seniors at Risk score >2 were eligible for inclusion. Additional patients were included if a member of the Emergency Department team felt that they would benefit from geriatric assessments and care coordination. Methods: This project, Geriatric Emergency Department Innovations in Care through Workforce Informatics and Structural Enhancements, is supported by a Center for Medicare & Medicaid Health Care Innovations Award. The geriatric nurse liaisons were four experienced emergency department nurses who received extensive training with geriatric and palliative care specialists and completed geriatric nurse education through the Nurses Improving Care for Healthsystem Elders program. Beginning in April 2013, the intervention was deployed using validated screening tools to identify seniors at risk for cognitive and functional decline, including the Identification of Seniors at Risk, Confusion Assessment Method, Short Portable Mental Status Questionnaire, Katz Index of Independence in Activities of Daily Living, Beers Criteria and Caregiver Strain Index. Care coordination efforts involved social work, physical therapy, pharmacy, and patient referral services. The geriatric nurse liaisons followed patients beyond their ED visit with phone calls at 24-72 hours 10-14 days. Results/Outcomes: From April 1, 2013 to July 5, 2013, 245 (of 1264 eligible and 4486 total) geriatric patients in the Emergency Department received the intervention. Over 90% of these were Emergency Severity Index 2 or 3 (88%: 2012 baseline). The discharge rate of the intervention cohort was 53% (38%), with 28% (45%) admitted to inpatient, and 19% (16%) to observation (2012 baseline). The average length of stay for patients discharged of the intervention cohort was 6.32 hrs (4.50, 2012 baseline). Implications: Focused assessments and care coordination for geriatric patients by a geriatric nurse liaison in the Emergency Department are feasible and may improve care and reduce admissions. This could significantly improve quality of life of older adults and reduce overall health care costs.
Keywords:
ED to Outpatient Setting; Geriatrics
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleGEDI WISE: Bridging the Gap from the ED to Homeen_GB
dc.contributor.authorBuckley, Barbara A.en_GB
dc.contributor.authorO'Connell Burke, Erinen_GB
dc.contributor.authorDobschuetz, Dwayneen_GB
dc.contributor.authorSalgado, Aliciaen_GB
dc.contributor.authorGEDI WISE Author Groupen_GB
dc.author.detailsBarbara A. Buckley, BSN, RN, email: bbuckley@nmh.org; Erin O'Connell Burke, BSN, RN; Dwayne Dobschuetz, MSN, RN; Alicia Salgado, BSN, RN; GEDI WISE Author Groupen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324171-
dc.description.abstractEvidence-based Practice Abstract Purpose: The number of Americans aged 65 or older will increase 36% from 40 million to 54.6 million by 2020. Heath care institutions must develop strategies to address the needs of this unique population. The Emergency Department is situated at the junction of outpatient and inpatient care and can be an effective facilitator in improving outcomes. The objective of this study is to implement a targeted intervention by a multidisciplinary team of clinicians to improve the health and quality of care of geriatric patients in the Emergency Department. Led by an innovative new clinician, the geriatric nurse liaison, the project aims to facilitate transition from the Emergency Department to the outpatient setting and reduce hospital admissions and readmissions. Design: This is a quality improvement project focusing on care coordination and geriatric assessment of Emergency Department patients. Setting: The overall project is a three-site collaboration. The present report describes the design at one site, an urban, academic Emergency Department with an annual volume of 85,000 visits per year, 18% of which are geriatric. Participants/Subjects: Patients 65 and older who arrived to the Emergency Department between the hours of 8am-6pm M-F, with an Identification of Seniors at Risk score >2 were eligible for inclusion. Additional patients were included if a member of the Emergency Department team felt that they would benefit from geriatric assessments and care coordination. Methods: This project, Geriatric Emergency Department Innovations in Care through Workforce Informatics and Structural Enhancements, is supported by a Center for Medicare & Medicaid Health Care Innovations Award. The geriatric nurse liaisons were four experienced emergency department nurses who received extensive training with geriatric and palliative care specialists and completed geriatric nurse education through the Nurses Improving Care for Healthsystem Elders program. Beginning in April 2013, the intervention was deployed using validated screening tools to identify seniors at risk for cognitive and functional decline, including the Identification of Seniors at Risk, Confusion Assessment Method, Short Portable Mental Status Questionnaire, Katz Index of Independence in Activities of Daily Living, Beers Criteria and Caregiver Strain Index. Care coordination efforts involved social work, physical therapy, pharmacy, and patient referral services. The geriatric nurse liaisons followed patients beyond their ED visit with phone calls at 24-72 hours 10-14 days. Results/Outcomes: From April 1, 2013 to July 5, 2013, 245 (of 1264 eligible and 4486 total) geriatric patients in the Emergency Department received the intervention. Over 90% of these were Emergency Severity Index 2 or 3 (88%: 2012 baseline). The discharge rate of the intervention cohort was 53% (38%), with 28% (45%) admitted to inpatient, and 19% (16%) to observation (2012 baseline). The average length of stay for patients discharged of the intervention cohort was 6.32 hrs (4.50, 2012 baseline). Implications: Focused assessments and care coordination for geriatric patients by a geriatric nurse liaison in the Emergency Department are feasible and may improve care and reduce admissions. This could significantly improve quality of life of older adults and reduce overall health care costs.en_GB
dc.subjectED to Outpatient Settingen_GB
dc.subjectGeriatricsen_GB
dc.date.available2014-08-04T13:28:47Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:47Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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