The Geriatric Emergency Care Applied Research (GEAR) Network

Dedicated to developing consensus papers and an overall research map for GEAR and GEM research.

Project Start: August 15, 2018
Project End: July 31, 2020
GEAR is funded by grant R21AG058926

Supported by the National Institutes of Health National Institute on Aging

NIH Project Reporter Summary


A research infrastructure in geriatric emergency care is needed to develop and test best practices in the ED setting that address the medical, health, and psychosocial needs of older patients. Despite evolution of interdisciplinary geriatric emergency department (GED) guidelines and the rapid growth and spread of self-declared GEDs, there is limited evidence of what better quality geriatric emergency care consists of and even less is known about the impact such care may have on patient outcomes. Thus, there is an imperative to advance interdisciplinary geriatric emergency medicine research.

Public Health Relevance

This project leverages the network of hospitals and health care systems who comprise the GEDC Partners – hospitals committed to implementing quality geriatric emergency care initiatives and build the Geriatric Emergency care Applied Research (GEAR) infrastructure. GEAR will create and support opportunities for multicenter studies and future grant proposals.

Why a Geriatric Emergency Care Applied Research Task Force?

With an aging U.S. population, there is an increasing demand for optimal, interactive care for older adults across emergency departments (EDs), hospitals, and health systems. However, the amount of strong evidence resulting in improved outcomes in geriatric emergency care is limited. The need for research in geriatric emergency medicine (GEM) was acknowledged early on by Lowell Gerson, PhD, who observed the disproportionate use of emergency departments by older persons and, with others, formed the Society for Academic Emergency Medicine Geriatric Emergency Medicine Task Force. Dr. Gerson’s work and mentorship has led to several developments, including the establishment of clinical guidelines and accreditation processes for geriatric emergency departments. The Geriatric Emergency Care Applied Research Network (GEAR), which aims to establish infrastructure to support collaborative, interdisciplinary research to improve care for older adults, is yet another result of that work.

The GEAR Task Force is developing consensus papers and an overall research map for GEAR and for GEM researchers in general. It began its work in Fall 2018 by generating and ranking questions focused on Populations, Interventions, Comparisons, and Outcomes (PICO questions). Subcommittees focused on five domains—cognitive impairment, medication safety, elder abuse, falls, and care transitions—conducted systematic reviews and synthesized the evidence for these questions, then developed priority questions based on their reviews.

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