The InterRAI ED Tool for Screening Older Patients in the Emergency Department: “What am I supposed to do with this?

Volume 5 | Issue 1 | Article 2 - Collective Wisdom: Editorial

Michael L. Malone, MD
Full Text

In a recent edition of JGEM, Matthew Downer and his colleagues from Sinai Health and University Health Network in Toronto describe the use of the interRAI Emergency Department screener in predicting the trajectories of health care utilization among older patients who presented to the emergency department (ED) in Toronto.1 Their goal was to determine if the rapid screening tool would be able to predict the health care utilization of older patients seen in the ED. A smartphone app was used by the triage nurse during the presentation of the patient, among a convenience sample. In short, the app was designed to define if an older patient had challenges in basic self- care (basic activities of daily living), cognition, caregiver burden, self-reported health, stability of prior conditions, dyspnea, and depression. The answers to the questions resulted in a low, medium and high risk of additional health care utilization. The authors mapped the trajectories of 755 older patients after their emergency department care. About 40% of the patients were hospitalized after their ED care. A quarter of the 755 patients were identified as high- risk at the time of their triage. Those with a high-risk score on the interRAI were more likely to be admitted to the hospital from the ED, more likely to stay longer in the hospital and receive a geriatric consultation. The tool was not helpful in identifying those who were at high risk of returning to the hospital in 30 days.

Join the mailing list to get the latest GEDC updates in your inbox!