Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use

Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use The U.S. healthcare system simultaneously faces rising inpatient costs and inefficient and inequitable care, with variable application of evidence‐based practices. These pressures may significantly affect one of the most vulnerable populations, older adults, at times of acute illness or injury. An emergency department (ED) visit is often described as a sentinel event signifying a breakdown in care coordination for older adults. With the ED at the crossroads of multiple healthcare settings, it has been described as “a portal of entry to inpatient care.” Both hospitalization and being discharged from the ED carry significant risks for older adults, including iatrogenic complications, functional and cognitive decline, and loss of independence. This highlights the importance of greater care to support transitions from the ED.Programs like Geriatric Emergency Department Innovations in Care through Workforce, Informatics, and Structural Enhancements (GEDI WISE) have been developed to address these challenges. GEDI WISE was a Center for Medicare and Medicaid Innovation (CMMI) Health Care Innovation Award program (1C1CMS331055–01). It is a model of geriatric emergency care in 3 large, urban hospitals (Mount Sinai Medical Center (MSMC), New York, NY; St. Joseph's Regional Medical Center (SJRMC), Paterson, NJ; Northwestern Memorial Hospital (NMH), Chicago, IL) that operationalizes the structural http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of American Geriatrics Society Wiley
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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 American Geriatrics Society and Wiley Periodicals, Inc.
ISSN
0002-8614
eISSN
1532-5415
D.O.I.
10.1111/jgs.15235
Publisher site
See Article on Publisher Site

Abstract

The U.S. healthcare system simultaneously faces rising inpatient costs and inefficient and inequitable care, with variable application of evidence‐based practices. These pressures may significantly affect one of the most vulnerable populations, older adults, at times of acute illness or injury. An emergency department (ED) visit is often described as a sentinel event signifying a breakdown in care coordination for older adults. With the ED at the crossroads of multiple healthcare settings, it has been described as “a portal of entry to inpatient care.” Both hospitalization and being discharged from the ED carry significant risks for older adults, including iatrogenic complications, functional and cognitive decline, and loss of independence. This highlights the importance of greater care to support transitions from the ED.Programs like Geriatric Emergency Department Innovations in Care through Workforce, Informatics, and Structural Enhancements (GEDI WISE) have been developed to address these challenges. GEDI WISE was a Center for Medicare and Medicaid Innovation (CMMI) Health Care Innovation Award program (1C1CMS331055–01). It is a model of geriatric emergency care in 3 large, urban hospitals (Mount Sinai Medical Center (MSMC), New York, NY; St. Joseph's Regional Medical Center (SJRMC), Paterson, NJ; Northwestern Memorial Hospital (NMH), Chicago, IL) that operationalizes the structural

Journal

Journal of American Geriatrics SocietyWiley

Published: Jan 1, 2018

Keywords: ; ;

References

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