Functional Assessment and Transitions of Care for Older ED Patients

A Geri-EM.com E-learning Module

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Course Summary

Older people, with complex medical and surgical problems, move through our EDs every day. Emergency physicians excel at rapid and focused management of their medical problems. However, we sometimes find the other necessary components of the assessment – cognitive, functional, psycho-social – to be challenging, time- and resource-intensive. Yet if we are to plan ED discharges that are safe and durable, all elements of that assessment need to be complete and excellent. And we know that management of such a complex situation cannot be handled by only one person – it’s a team sport.

This module follows three patients to the Emergency Department – all straightforward on the face of things, but complex once you dig deeper. We suggest a framework, some tools, and strategies for assessing ALL the components of their presentations. And we suggest some best practices for the most complicated of transitions – ED to nursing home.

Learning Objectives

Upon conclusion of this activity, participants should be able to:

1. List strategies for gathering information about an older patient in the ED.
2. Identify essential parts of a discharge plan for an older patient (the importance of cognitive and functional assessment, ambulation, ability to provide self-care, safety and establishing a follow-up plan appropriate for the vulnerable older patient.
3. Name the Activities of Daily Living and Instrumental Activities of Daily Living and link them to safe ED discharge.
4. Establish members of the health-care team with whom to share care tasks; (ED nurse, family physician, community care provider, long-term care providers; ambulance crew)
5. List strategies for communicating with “downstream” care providers. (call long-term care; send written information back to LTC; fax a copy of chart or discharge summary to family doctor; provide a legible written copy of clinical record and plan to the patient; notify in writing the community care nurse about changes in care plan.)

Attendance at this Mayo Clinic accredited course does not indicate nor guarantee competence or proficiency in the performance of any procedures which may be discussed or taught in this course.

Accreditation Statement

In support of improving patient care, Mayo Clinic College of Medicine and Science, and the Geriatric Emergency Department Collaborative. Mayo Clinic College of Medicine and Science is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Credit Statements

AMA

Mayo Clinic College of Medicine and Science designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ANCC

Mayo Clinic College of Medicine and Science designates this activity for a maximum of 1.00 ANCC contact hours. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Activity Description

The Online Learning offerings from GEDC include modules developed from the Geri-EM.com e-learning program, modules from the National Collaboratory to Address Elder Mistreatment, and modules developed by GEDC’s clinical experts on Falls and Mobility clinical training. Through practical text and interactive exercises, including opportunities to apply key content to realistic emergency department-based scenarios, users will build knowledge and skills in Geriatric ED care.
Each course provides downloadable resources and a reference list of essential reading in the topic area. Each module may stand alone to reinforce learning in a particular area of interest, or the modules can be completed in succession to cover all areas in Geriatric ED care. Users access the modules via a course catalog at gedcollaborative.com/online-learning/ and can participate any time from a computer, tablet, or smartphone.

Target Audience

Allied Health Professional, Healthcare Executive, Nurse, Nurse Practitioner, Pharmacist, Physician, Physician Assistant, Resident Fellow, Social Worker, Student

Method of Participation

Participation in this activity consists of reviewing the educational material, and completing the learner assessment and evaluation.

How to Obtain Credit

To obtain credit, users must complete the course material (progress is tracked), and complete the evaluation with a score of 80% or more within two attempts. After this is completed, learners will obtain their credit certificate.

Release and Expiration Dates

Release Date:
Expiration Date: 12/31/2024

Disclosure Summary

As a provider accredited by Joint Accreditation for Interprofessional Continuing Education, Mayo Clinic College of Medicine and Science must ensure balance, independence, objectivity and scientific rigor in its educational activities. All who are in a position to control the content are required to disclose all financial relationships with any ineligible company. Faculty will also identify any off-label and/or investigational use of pharmaceuticals or instruments discussed in their content for FDA compliance.

Listed below are individuals with control of the content of this program who have disclosed…

Relevant financial relationship(s) with ineligible companies:
Kevin Biese – Owner/employee – Third Eye Tele Health

All relevant financial relationships listed for these individuals have been mitigated.

No relevant financial relationship(s) with ineligible companies:
Don Melady, Aaron Malsch, Marie-Pier Lanoue

References to off-label and/or investigational usage(s) of pharmaceuticals or instruments in their presentation:
None

For disclosure information regarding Mayo Clinic School of Continuous Professional Development accreditation review committee member(s) please visit: https://ce.mayo.edu/content/disclosures.

Acknowledgement of Commercial Support

No commercial support was received in the production of this activity.

Bibliographic References

Bibliographic resources are provided within the activity.

Disclaimer & Copyright

Participation in this Mayo Clinic accredited educational activity does not indicate nor guarantee competence or proficiency in the performance of any procedures which may be discussed or taught in this course. You should be aware that substantive developments in the medical field covered by this recording may have occurred since the date of the original release.