Abstract
Introduction
To accommodate the complex healthcare needs of the rising geriatric population, Stamford Hospital’s (SH) emergency department (ED) began a Geriatric Emergency Medicine Initiative (GEMI) in 2018 to improve our ED environment, practices, and focused assessments for our community-dwelling older adults.
Methods
This retrospective program evaluation describes SH’s novel ED processes for at-risk older adults and compares GEMI and non-GEMI assessed patient outcomes using aggregate frequencies on throughput metrics such as length of stay (LOS), 72 hour and 30-day re-admission rates, and other outcomes of interest. Chi-square tests and group t-tests were used for all analyses with a p-value of 0.05.
Results
GEMI-assessed patients had a significantly lower 30-day all cause re-admission rate for fiscal year 2022 (readmission rate = 2%) when compared to the non-GEMI assessed cohort (readmission rate = 4.9%). GEMI-assessed patients were more likely to be admitted (25% vs 21%) and had a longer LOS in the ED observation unit but were less likely to return within 72 hours for a subsequent hospital admission (24% vs 28%, respectively).
Conclusion
SH’s ED solidified its care pathway by creating the GEMI program with the goal of decreasing hospital admissions and reducing the LOS for at risk older adults. Successful implementation and care coordination by trained geriatric nurses optimized innovative system changes. These results are promising and reflect the substantial value the GEMI program offers to the communities we serve.