Four Models of Care for Geriatric EDs
With Dr. Lauren Southerland
Many EDs around the world are working to become Geriatric EDs or geriatric-friendly EDs. Dr. Lauren Southerland led a group that looked at what models of care different EDs were using to become accredited geriatric EDs. They found four basic themes or models. Here we discuss the four models, and why one or the other may work best in a given health care system.
For information on how to become an accredited Geriatric ED, see the ACEP GEDA site.
The four models of care we discuss are:
- A separate Geri ED unit with separate space and clinicians and additional staff (such as pharmacist, social worker, geriatrics-trained RN or APP.
- Geriatrics practitioner model, where a dedicated team can assess patients and perform additional screening or arrange additional services, but patients are seen in the same space as other patients and by the same clinicians.
- Geriatrics champion model, where there are designated RN and physician champions who help lead change, implement protocols and educational programs, and monitor progress.
- Observation Unit model, using the extending time and resources provided by Observation status in the ED to incorporate a multidisciplinary geriatric assessment and other resources such as consults or PT/OT.
- The full article on models of care by Dr. Southerland can be found at the Annals of Emergency Medicine and through ACEP here: Southerland et al, Ann Emerg Med. 2020 Feb;75(2):162-170. doi: 10.1016/j.annemergmed.2019.08.430. Epub 2019 Nov 13.
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Dr. Christina Shenvi is an associate professor of Emergency Medicine at the University of North Carolina. She is fellowship-trained in Geriatric Emergency Medicine and is the founder of GEMCast. She is the director of the UNC Office of Academic Excellence, president of the Association of Professional Women in Medical Sciences, co-directs the ACEP/CORD Teaching Fellowship, is on the Annals of EM editorial board, is on the Geriatric ED Accreditation board of governors, and she teaches and writes about time management at timeforyourlife.org.