Introduction:
The Geriatric Emergency Department Team (GEDT) is a new multidisciplinary service within a Perth metropolitan hospital emergency department (ED). It functions as a consulting service, operating 8am-4pm Monday to Friday. It aims to improve the care of frail older adults presenting to ED by providing early comprehensive geriatric assessment and safe disposition planning.
Aim:
To improve the care of clinically frail older adults and minimise hospital admissions through facilitation of a safe and supported discharge.
Methods:
The GEDT consists of a geriatrician, registrar, nurse practitioner, physiotherapist, occupational therapist and social worker. The service targets patients aged 65+ years old with geriatric syndromes including cognitive impairment, falls and social issues. Suitable patients were referred from ED clinical staff or self-identified by GEDT members. An excel database was set up to capture clinical data of each patient assessed by the GEDT from February 2022 until February 2023. The frailty score by Clinical Frailty Scale (CFS)1 and disposition were analysed.
Results:
Over a 12 month period, GEDT saw a total of 1008 patients. Of these, 816 (81.0%) had a CFS score of > 4. A total of 556 patients (55.1%) seen by GEDT were discharged from ED. Of these, 124 patients (22.3%) were successful admission diversions, as defined by patients who had admission processes in place but were subsequently discharged from ED following GEDT intervention.
Conclusions:
The GEDT can reduce hospital admissions amongst frail older adults presenting to ED through early geriatric-focussed assessment and safe discharge planning.