Strategies to improve care for older adults who present to the emergency department: a systematic review.
Complex system
Indicators
Patient safety
Quality
Urgent healthcare
Value-based care
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
08 Feb 2024
08 Feb 2024
Historique:
received:
30
10
2023
accepted:
08
01
2024
medline:
9
2
2024
pubmed:
9
2
2024
entrez:
8
2
2024
Statut:
epublish
Résumé
The aim of this systematic review was to examine the relationship between strategies to improve care delivery for older adults in ED and evaluation measures of patient outcomes, patient experience, staff experience, and system performance. A systematic review of English language studies published since inception to December 2022, available from CINAHL, Embase, Medline, and Scopus was conducted. Studies were reviewed by pairs of independent reviewers and included if they met the following criteria: participant mean age of ≥ 65 years; ED setting or directly influenced provision of care in the ED; reported on improvement interventions and strategies; reported patient outcomes, patient experience, staff experience, or system performance. The methodological quality of the studies was assessed by pairs of independent reviewers using The Joanna Briggs Institute critical appraisal tools. Data were synthesised using a hermeneutic approach. Seventy-six studies were included in the review, incorporating strategies for comprehensive assessment and multi-faceted care (n = 32), targeted care such as management of falls risk, functional decline, or pain management (n = 27), medication safety (n = 5), and trauma care (n = 12). We found a misalignment between comprehensive care delivered in ED for older adults and ED performance measures oriented to rapid assessment and referral. Eight (10.4%) studies reported patient experience and five (6.5%) reported staff experience. It is crucial that future strategies to improve care delivery in ED align the needs of older adults with the purpose of the ED system to ensure sustainable improvement effort and critical functioning of the ED as an interdependent component of the health system. Staff and patient input at the design stage may advance prioritisation of higher-impact interventions aligned with the pace of change and illuminate experience measures. More consistent reporting of interventions would inform important contextual factors and allow for replication.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this systematic review was to examine the relationship between strategies to improve care delivery for older adults in ED and evaluation measures of patient outcomes, patient experience, staff experience, and system performance.
METHODS
METHODS
A systematic review of English language studies published since inception to December 2022, available from CINAHL, Embase, Medline, and Scopus was conducted. Studies were reviewed by pairs of independent reviewers and included if they met the following criteria: participant mean age of ≥ 65 years; ED setting or directly influenced provision of care in the ED; reported on improvement interventions and strategies; reported patient outcomes, patient experience, staff experience, or system performance. The methodological quality of the studies was assessed by pairs of independent reviewers using The Joanna Briggs Institute critical appraisal tools. Data were synthesised using a hermeneutic approach.
RESULTS
RESULTS
Seventy-six studies were included in the review, incorporating strategies for comprehensive assessment and multi-faceted care (n = 32), targeted care such as management of falls risk, functional decline, or pain management (n = 27), medication safety (n = 5), and trauma care (n = 12). We found a misalignment between comprehensive care delivered in ED for older adults and ED performance measures oriented to rapid assessment and referral. Eight (10.4%) studies reported patient experience and five (6.5%) reported staff experience.
CONCLUSION
CONCLUSIONS
It is crucial that future strategies to improve care delivery in ED align the needs of older adults with the purpose of the ED system to ensure sustainable improvement effort and critical functioning of the ED as an interdependent component of the health system. Staff and patient input at the design stage may advance prioritisation of higher-impact interventions aligned with the pace of change and illuminate experience measures. More consistent reporting of interventions would inform important contextual factors and allow for replication.
Identifiants
pubmed: 38331778
doi: 10.1186/s12913-024-10576-1
pii: 10.1186/s12913-024-10576-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
178Subventions
Organisme : Australian Government Medical Research Future Fund
ID : APP2018361
Organisme : Australian Government Medical Research Future Fund
ID : APP2018361
Organisme : Australian Government Medical Research Future Fund
ID : APP2018361
Organisme : Australian Government Medical Research Future Fund
ID : APP2018361
Informations de copyright
© 2024. The Author(s).
Références
United Nations; Department of Economic and Social Affairs; Population Division. World Population Prospects 2022: Summary of Results. UN DESA/POP/2022/TR/NO. 3. New York: United Nations; 2022.
Australian Institute of Health and Welfare. Emergency department care. Available from: https://www.aihw.gov.au/reports-data/myhospitals/sectors/emergency-department-care . [Cited 30 March 2023].
Lowthian J, Curtis A, Stoelwinder J, McNeil J, Cameron P. Emergency demand and repeat attendances by older patients. Intern Med J. 2013;43(5):554–60.
pubmed: 23279076
doi: 10.1111/imj.12061
Samaras N, Chevalley T, Samaras D, Gold G. Older patients in the emergency department: a review. Ann Emerg Med. 2010;56(3):261–9.
pubmed: 20619500
doi: 10.1016/j.annemergmed.2010.04.015
McIntyre A, Janzen S, Shepherd L, Kerr M, Booth R. An integrative review of adult patient-reported reasons for non-urgent use of the emergency department. BMC Nurs. 2023;22(1):85.
pubmed: 36991388
pmcid: 10061911
doi: 10.1186/s12912-023-01251-7
Epstein SK, Huckins DS, Liu SW, Pallin DJ, Sullivan AF, Lipton RI, et al. Emergency department crowding and risk of preventable medical errors. Intern Emerg Med. 2012;7(2):173–80.
pubmed: 22009553
doi: 10.1007/s11739-011-0702-8
Trzeciak S, Rivers E. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J. 2003;20(5):402–5.
pubmed: 12954674
pmcid: 1726173
doi: 10.1136/emj.20.5.402
Stein-Parbury J, Gallagher R, Fry M, Chenoweth L, Gallagher P. Expectations and experiences of older people and their carers in relation to emergency department arrival and care: a qualitative study in Australia. Nurs Health Sci. 2015;17(4):476–82.
pubmed: 26086526
doi: 10.1111/nhs.12220
Carter EJ, Pouch SM, Larson EL. The relationship between emergency department crowding and patient outcomes: A systematic review. J Nurs Scholarsh. 2014;46(2):106–15.
pubmed: 24354886
doi: 10.1111/jnu.12055
Bernstein SL, Aronsky D, Duseja R, Epstein S, Handel D, Hwang U, et al. The effect of Emergency Department crowding on clinically oriented outcomes. Acad Emerg Med. 2009;16(1):1–10.
pubmed: 19007346
doi: 10.1111/j.1553-2712.2008.00295.x
Richardson DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust. 2006;184(5):213–6.
pubmed: 16515430
doi: 10.5694/j.1326-5377.2006.tb00204.x
Zhang Q, Mu MC, He Y, Cai ZL, Li ZC. Burnout in emergency medicine physicians: a meta-analysis and systematic review. Medicine. 2020;99(32):e21462.
pubmed: 32769876
pmcid: 7593073
doi: 10.1097/MD.0000000000021462
Epstein EG, Whitehead PB, Prompahakul C, Thacker LR, Hamric AB. Enhancing understanding of moral distress: the measure of moral distress for health care professionals. AJOB empirical bioethics. 2019;10(2):113–24.
pubmed: 31002584
doi: 10.1080/23294515.2019.1586008
Testa L, Seah R, Ludlow K, Braithwaite J, Mitchell RJ. Models of care that avoid or improve transitions to hospital services for residential aged care facility residents: An integrative review. Geriatr Nurs. 2020;41(4):360–72.
pubmed: 30876676
doi: 10.1016/j.gerinurse.2019.02.001
Carpenter CR, Shelton E, Fowler S, Suffoletto B, Platts-Mills TF, Rothman RE, et al. Risk Factors and Screening Instruments to Predict Adverse Outcomes for Undifferentiated Older Emergency Department Patients: a systematic review and Meta-analysis. Acad Emerg Med. 2015;22(1):1–21.
pubmed: 25565487
doi: 10.1111/acem.12569
Benito D. Ortho-geriatric Care. In: Nagaratnam N, Nagaratnam K, Cheuk G, editors. Advanced Age Geriatric Care: A Comprehensive Guide. Cham: Springer International Publishing; 2019. p. 53–61.
doi: 10.1007/978-3-319-96998-5_8
Leigheb F, Vanhaecht K, Sermeus W, Lodewijckx C, Deneckere S, Boonen S, et al. The effect of care pathways for hip fractures: a systematic review. Calcif Tissue Int. 2012;91(1):1–14.
pubmed: 22476267
doi: 10.1007/s00223-012-9589-2
Larsson S, Clawson J, Howard R. Value-based health care at an inflection point: a global agenda for the next decade. NEJM Catal Innov Care Deliv. 2023;4(1):1–22.
Sarkies MN, Francis-Auton E, Long JC, Partington A, Pomare C, Nguyen HM, et al. Implementing large-system, value-based healthcare initiatives: a realist study protocol for seven natural experiments. BMJ Open. 2020;10(12):e044049.
pubmed: 33371049
pmcid: 7757496
doi: 10.1136/bmjopen-2020-044049
Koff E, Lyons N. Implementing value-based health care at scale: the NSW experience. Med J Aust. 2020;212(3):104-6.e1.
pubmed: 31909479
doi: 10.5694/mja2.50470
Braithwaite J, Glasziou P, Westbrook J. The three numbers you need to know about healthcare: the 60–30-10 challenge. BMC Med. 2020;18:1–8.
doi: 10.1186/s12916-020-01563-4
Preston L, van Oppen JD, Conroy SP, Ablard S, Buckley Woods H, Mason SM. Improving outcomes for older people in the emergency department: a review of reviews. Emerg Med J. 2021;38(12):882–8.
pubmed: 33106287
doi: 10.1136/emermed-2020-209514
Berning MJ, Oliveira JESL, Suarez NE, Walker LE, Erwin P, Carpenter CR, et al. Interventions to improve older adults’ Emergency Department patient experience: a systematic review. Am J Emerg Med. 2020;38(6):1257–69.
pubmed: 32222314
doi: 10.1016/j.ajem.2020.03.012
Cheek C, Hayba N, Richardson L, Austin EE, Auton EF, Safi M, et al. Experience-based codesign approach to improve care in Australian emergency departments for complex consumer cohorts: the MyED project protocol, Stages 1.1–1.3. BMJ Open. 2023;13(7):e072908.
pubmed: 37407042
pmcid: 10335419
doi: 10.1136/bmjopen-2023-072908
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):89.
pubmed: 33781348
pmcid: 8008539
doi: 10.1186/s13643-021-01626-4
Clay-Williams R, Austin E, Cheek C, Churruca K, Francis-Auton E, Hayba N, et al. Strategies to improve care for aged patients who present to the Emergency Department (ED): a systematic review protocol 2022. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022355599 .
JBI. Critical appraisal tools: JBI. Available from: https://jbi.global/critical-appraisal-tools . [Cited 31 August 2023].
MacLeod ML, McCaffrey G, Wilson E, Zimmer LV, Snadden D, Zimmer P, et al. Exploring the intersection of hermeneutics and implementation: a scoping review. Syst Rev. 2023;12(1):1–21.
doi: 10.1186/s13643-023-02176-7
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE: The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906.
Liu J, Palmgren T, Ponzer S, Masiello I, Farrokhnia N. Can dedicated emergency team and area for older people reduce the hospital admission rate? - An observational pre- and post-intervention study. BMC Geriatr. 2021;21(1):115.
pubmed: 33568087
pmcid: 7877031
doi: 10.1186/s12877-021-02044-w
Keyes DC, Singal B, Kropf CW, Fisk A. Impact of a new senior emergency department on emergency department recidivism, rate of hospital admission, and hospital length of stay. Ann Emerg Med. 2014;63(5):517–24.
pubmed: 24342817
doi: 10.1016/j.annemergmed.2013.10.033
Heeren P, Devriendt E, Fieuws S, Wellens NIH, Deschodt M, Flamaing J, et al. Unplanned readmission prevention by a geriatric emergency network for transitional care (URGENT): a prospective before-after study. BMC Geriatr. 2019;19(1):215.
pubmed: 31390994
pmcid: 6686568
doi: 10.1186/s12877-019-1233-9
Goldberg EM, Marks SJ, Resnik LJ, Long S, Mellott H, Merchant RC. Can an Emergency Department-Initiated Intervention Prevent Subsequent Falls and Health Care Use in Older Adults? A Randomized Controlled Trial. Ann Emerg Med. 2020;76(6):739–50.
pubmed: 32854965
pmcid: 7686139
doi: 10.1016/j.annemergmed.2020.07.025
Goldberg EM, Marks SJ, Ilegbusi A, Resnik L, Strauss DH, Merchant RC. GAPcare: the geriatric acute and post-acute fall prevention intervention in the emergency department: preliminary data. J Am Geriatr Soc. 2020;68(1):198–206.
pubmed: 31621901
doi: 10.1111/jgs.16210
Ellis G, Jamieson CA, Alcorn M, Devlin V. An Acute Care for Elders (ACE) unit in the emergency department. European Geriatric Medicine. 2012;3(4):261–3.
doi: 10.1016/j.eurger.2012.03.004
Conroy SP, Ansari K, Williams M, Laithwaite E, Teasdale B, Dawson J, et al. A controlled evaluation of comprehensive geriatric assessment in the emergency department: the “Emergency Frailty Unit.” Age Ageing. 2014;43(1):109–14.
pubmed: 23880143
doi: 10.1093/ageing/aft087
Bosetti A, Gayot C, Preux PM, Tchalla A. Effectiveness of a Geriatric Emergency Medicine Unit for the Management of Neurocognitive Disorders in Older Patients: Results of the MUPACog Study. Dement Geriatr Cogn Disord. 2020;49(4):394–400.
pubmed: 33333527
doi: 10.1159/000510054
Blomaard LC, de Groot B, Lucke JA, de Gelder J, Booijen AM, Gussekloo J, et al. Implementation of the acutely presenting older patient (APOP) screening program in routine emergency department care : A before-after study. Z Gerontol Geriatr. 2021;54(2):113–21.
pubmed: 33471176
pmcid: 7946672
doi: 10.1007/s00391-020-01837-9
Beauchet O, Lubov J, Galery K, Afilalo M, Launay CP. Emergency room evaluation and recommendations for older emergency department users: results of the ER2 experimental study. Eur Geriatr Med. 2021;12(5):921–9.
pubmed: 34089148
doi: 10.1007/s41999-021-00517-0
Beauchet O, Afilalo M, Allali G, Lubov J, Galery K, Launay CP. “Emergency Room Evaluation and Recommendations” and Incident Hospital Admissions in Older People with Major Neurocognitive Disorders Visiting Emergency Department: Results of an Experimental Study. Dement Geriatr Cogn Disord. 2022;51(3):291–6.
pubmed: 35551122
doi: 10.1159/000524533
Arendts G, Fitzhardinge S, Pronk K, Hutton M. Outcomes in older patients requiring comprehensive allied health care prior to discharge from the emergency department. Emerg Med Australas. 2013;25(2):127–31.
pubmed: 23560962
doi: 10.1111/1742-6723.12049
Aldeen AZ, Courtney DM, Lindquist LA, Dresden SM, Gravenor SJ. Geriatric emergency department innovations: preliminary data for the geriatric nurse liaison model. J Am Geriatr Soc. 2014;62(9):1781–5.
pubmed: 25112656
doi: 10.1111/jgs.12979
Guttman A, Afilalo M, Guttman R, Colacone A, Robitaille C, Lang E, et al. An emergency department-based nurse discharge coordinator for elder patients: does it make a difference? Acad Emerg Med. 2004;11(12):1318–27.
pubmed: 15576523
doi: 10.1197/j.aem.2004.07.006
Dresden SM, Hwang U, Garrido MM, Sze J, Kang R, Vargas-Torres C, et al. Geriatric Emergency Department Innovations: The Impact of Transitional Care Nurses on 30-day Readmissions for Older Adults. Acad Emerg Med. 2020;27(1):43–53.
pubmed: 31663245
doi: 10.1111/acem.13880
Keene SE, Cameron-Comasco L. Implementation of a geriatric emergency medicine assessment team decreases hospital length of stay. Am J Emerg Med. 2022;55:45–50.
pubmed: 35276545
doi: 10.1016/j.ajem.2022.02.027
Silvester KM, Mohammed MA, Harriman P, Girolami A, Downes TW. Timely care for frail older people referred to hospital improves efficiency and reduces mortality without the need for extra resources. Age Ageing. 2014;43(4):472–7.
pubmed: 24222658
doi: 10.1093/ageing/aft170
Marsden E, Craswell A, Taylor A, Barnett A, Wong PK, Wallis M. Translation of the geriatric emergency department intervention into other emergency departments: a post implementation evaluation of outcomes for older adults. BMC Geriatr. 2022;22(1):290.
pubmed: 35392828
pmcid: 8988321
doi: 10.1186/s12877-022-02999-4
Southerland LT, Vargas AJ, Nagaraj L, Gure TR, Caterino JM. An emergency department observation unit is a feasible setting for multidisciplinary geriatric assessments in compliance with the geriatric emergency department guidelines. Acad Emerg Med. 2018;25(1):76–82.
pubmed: 28975679
doi: 10.1111/acem.13328
Warburton RN. Preliminary outcomes and cost-benefit analysis of a community hospital emergency department screening and referral program for patients aged 75 or more. Int J Health Care Qual Assur Inc Leadersh Health Serv. 2005;18(6–7):474–84.
pubmed: 16335613
doi: 10.1108/09526860510619453
Wallis M, Marsden E, Taylor A, Craswell A, Broadbent M, Barnett A, et al. The Geriatric Emergency Department Intervention model of care: a pragmatic trial. BMC Geriatr. 2018;18(1):297.
pubmed: 30509204
pmcid: 6276263
doi: 10.1186/s12877-018-0992-z
Vivanti A, Isenring E, Baumann S, Powrie D, O’Neill M, Clark D, et al. Emergency department malnutrition screening and support model improves outcomes in a pilot randomised controlled trial. Emerg Med J. 2015;32(3):180–3.
pubmed: 24192128
doi: 10.1136/emermed-2013-202965
Hullick C, Conway J, Higgins I, Hewitt J, Stewart B, Dilworth S, et al. An assistant workforce to improve screening rates and quality of care for older patients in the emergency department: findings of a pre- post, mixed methods study. BMC Geriatr. 2018;18(1):126.
pubmed: 29843623
pmcid: 5975558
doi: 10.1186/s12877-018-0811-6
Huded JM, Lee A, Song S, McQuown CM, Wilson BM, Smith TI, et al. Association of a geriatric emergency department program with healthcare outcomes among veterans. J Am Geriatr Soc. 2022;70(2):601–8.
pubmed: 34820827
doi: 10.1111/jgs.17572
Ngian VJ, Ong BS, O’Rourke F, Nguyen HV, Chan DK. Review of a rapid geriatric medical assessment model based in emergency department. Age Ageing. 2008;37(6):696–9.
pubmed: 18703521
doi: 10.1093/ageing/afn160
Lee V, Ross B, Tracy B. Functional assessment of older adults in an emergency department. Can J Occup Ther. 2001;68(2):121–9.
pubmed: 11355617
doi: 10.1177/000841740106800208
Corbett HM, Lim WK, Davis SJ, Elkins AM. Care coordination in the Emergency Department: improving outcomes for older patients. Aust Health Rev. 2005;29(1):43–50.
pubmed: 15683355
doi: 10.1071/AH050043
Argento V, Calder G, Ferrigno R, Skudlarska B. Geriatric emergency medicine service: a novel approach to an emerging trend. Conn Med. 2014;78(6):339–43.
pubmed: 25672060
Palonen M, Kaunonen M, Helminen M, Åstedt-Kurki P. Discharge education for older people and family members in emergency department: a cross-sectional study. Int Emerg Nurs. 2015;23(4):306–11.
pubmed: 25770988
doi: 10.1016/j.ienj.2015.02.003
McGrath J, Almeida P, Law R. The Whittington Frailty Pathway: improving access to comprehensive geriatric assessment: an interdisciplinary quality improvement project. BMJ open quality. 2019;8(4):e000798.
pubmed: 31803856
pmcid: 6887502
doi: 10.1136/bmjoq-2019-000798
Blomaard LC, Olthof M, Meuleman Y, de Groot B, Gussekloo J, Mooijaart SP. Experiences with and attitudes towards geriatric screening among older emergency department patients: a qualitative study. BMC Geriatr. 2021;21(1):198.
pubmed: 33743607
pmcid: 7981953
doi: 10.1186/s12877-021-02144-7
O’Grady S, Fairbrother G. Matching needs to services: The quick response. Aust Health Rev. 1996;19(4):100–12.
pubmed: 10165289
doi: 10.1071/AH960100
McCusker J, Jacobs P, Dendukuri N, Latimer E, Tousignant P, Verdon J. Cost-effectiveness of a brief two-stage emergency department intervention for high-risk elders: results of a quasi-randomized controlled trial. Ann Emerg Med. 2003;41(1):45–56.
pubmed: 12514682
doi: 10.1067/mem.2003.4
McCusker J, Dendukuri N, Tousignant P, Verdon J, de Poulin Courval L, Belzile E. Rapid two-stage emergency department intervention for seniors: impact on continuity of care. Acad Emerg Med. 2003;10(3):233–43.
pubmed: 12615589
Basic D, Conforti DA. A prospective, randomised controlled trial of an aged care nurse intervention within the Emergency Department. Aust Health Rev. 2005;29(1):51–9.
pubmed: 15683356
doi: 10.1071/AH050051
Basic D, Conforti D, Rowland J. Standardised assessment of older patients by a nurse in an emergency department. Aust Health Rev. 2002;25(4):50–8.
pubmed: 12404966
doi: 10.1071/AH020050
Chong E, Zhu B, Tan H, Molina JC, Goh EF, Baldevarona-Llego J, et al. Emergency Department Interventions for Frailty (EDIFY): front-door geriatric care can reduce acute admissions. J Am Med Dir Assoc. 2021;22(4):923-8.e5.
pubmed: 33675695
doi: 10.1016/j.jamda.2021.01.083
Miller DK, Lewis LM, Nork MJ, Morley JE. Controlled trial of a geriatric case-finding and liaison service in an emergency department. J Am Geriatr Soc. 1996;44(5):513–20.
pubmed: 8617898
doi: 10.1111/j.1532-5415.1996.tb01435.x
PuigCampmany M, RisRomeu J, BlazquezAndion M, Benito VS. Development of a comprehensive, multidisciplinary program of care for frailty in an emergency department. Eur Geriatr Med. 2019;10(1):37–46.
doi: 10.1007/s41999-018-0151-2
Tousignant-Laflamme Y, Beaudoin AM, Renaud AM, Lauzon S, Charest-Bosse MC, Leblanc L, et al. Adding physical therapy services in the emergency department to prevent immobilization syndrome - a feasibility study in a university hospital. BMC Emerg Med. 2015;15:35.
pubmed: 26635006
pmcid: 4669664
doi: 10.1186/s12873-015-0062-1
Ageron FX, Ricard C, Perrin-Besson S, Picot F, Dumont O, Cabillic S, et al. Effectiveness of a Multimodal Intervention Program for Older Individuals Presenting to the Emergency Department After a Fall in the Northern French Alps Emergency Network. Acad Emerg Med. 2016;23(9):1031–9.
pubmed: 27144990
doi: 10.1111/acem.12989
O’Keeffe A, O’Grady S, Cronin F, Dolan C, O’Hea A, O’Shea KL, et al. Evaluation of an emergency department falls pathway for older people: a patient chart review. Int Emerg Nurs. 2020;51:100869.
pubmed: 32354620
doi: 10.1016/j.ienj.2020.100869
Liberman T, Kozikowski A, Kwon N, Emmert B, Akerman M, Pekmezaris R. Identifying Advanced Illness Patients in the Emergency Department and Having Goals-of-Care Discussions to Assist with Early Hospice Referral. J Emerg Med. 2018;54(2):191–7.
pubmed: 28988735
doi: 10.1016/j.jemermed.2017.08.009
Brymer C, Cavanagh P, Denomy E, Wells K, Cook C. The effect of a geriatric education program on emergency nurses. J Emerg Nurs. 2001;27(1):27–32.
pubmed: 11174267
doi: 10.1067/men.2001.112282
Newton-Brown E, Fitzgerald L, Mitra B. Audit improves emergency department triage, assessment, multi-modal analgesia and nerve block use in the management of pain in older people with neck of femur fracture. Australas Emerg Nurs J. 2014;17(4):176–83.
pubmed: 25151180
doi: 10.1016/j.aenj.2014.06.001
Scarpazza P, Incorvaia C, di Franco G, Raschi S, Usai P, Bernareggi M, et al. Effect of noninvasive mechanical ventilation in elderly patients with hypercapnic acute-on-chronic respiratory failure and a do-not-intubate order. Int J Chron Obstruct Pulmon Dis. 2008;3(4):797–801.
pubmed: 19281095
pmcid: 2650611
Foo CL, Siu VW, Tan TL, Ding YY, Seow E. Geriatric assessment and intervention in an emergency department observation unit reduced re-attendance and hospitalisation rates. Australas J Ageing. 2012;31(1):40–6.
pubmed: 22417153
doi: 10.1111/j.1741-6612.2010.00499.x
Foo CL, Siu VW, Ang H, Phuah MW, Ooi CK. Risk stratification and rapid geriatric screening in an emergency department - a quasi-randomised controlled trial. BMC Geriatr. 2014;14:98.
pubmed: 25178312
pmcid: 4161268
doi: 10.1186/1471-2318-14-98
Chong E, Zhu B, Ng SHX, Tan H, Goh EF, Molina JDC, et al. Emergency department interventions for frailty (EDIFY): improving functional outcomes in older persons at the emergency department through a multicomponent frailty intervention. Age and Ageing. 2022;51(2):afab251.
pubmed: 35134848
doi: 10.1093/ageing/afab251
Lesser A, Israni J, Kent T, Ko KJ. Association between physical therapy in the emergency department and emergency department revisits for older adult fallers: a nationally representative analysis. J Am Geriatr Soc. 2018;66(11):2205–12.
pubmed: 30132800
doi: 10.1111/jgs.15469
Hogan TM, Howell MD, Cursio JF, Wong A, Dale W. Improving Pain Relief in Elder Patients (I-PREP): an emergency department education and quality intervention. J Am Geriatr Soc. 2016;64(12):2566–71.
pubmed: 27806183
doi: 10.1111/jgs.14377
Shaw FE, Bond J, Richardson DA, Dawson P, Steen IN, McKeith IG, et al. Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial. BMJ. 2003;326(7380):73.
pubmed: 12521968
pmcid: 139930
doi: 10.1136/bmj.326.7380.73
Mahony SO, Blank A, Simpson J, Persaud J, Huvane B, McAllen S, et al. Preliminary report of a palliative care and case management project in an emergency department for chronically ill elderly patients. J Urban Health. 2008;85(3):443–51.
pubmed: 18363108
pmcid: 2329741
doi: 10.1007/s11524-008-9257-z
McCusker J, Verdon J, Tousignant P, de Courval LP, Dendukuri N, Belzile E. Rapid emergency department intervention for older people reduces risk of functional decline: results of a multicenter randomized trial. J Am Geriatr Soc. 2001;49(10):1272–81.
pubmed: 11890484
doi: 10.1046/j.1532-5415.2001.49254.x
Boucher V, Lamontagne ME, Lee J, Carmichael PH, Déry J, Émond M. Acceptability of older patients’ self-assessment in the Emergency Department (ACCEPTED)-a randomised cross-over pilot trial. Age Ageing. 2019;48(6):875–80.
pubmed: 31297513
doi: 10.1093/ageing/afz084
Liberman T, Roofeh R, Sohn N, Brave M, Smith A, Willis H, et al. The GAP-ED Project: Improving Care for Elderly Patients Presenting to the Emergency Department. J Emerg Med. 2020;58(2):191–7.
pubmed: 31810831
doi: 10.1016/j.jemermed.2019.10.006
Elliott A, Phelps K, Regen E, Conroy SP. Identifying frailty in the Emergency Department-feasibility study. Age Ageing. 2017;46(5):840–5.
pubmed: 28541400
doi: 10.1093/ageing/afx089
Arendts G, Leyte N, Dumas S, Ahamed S, Khokulan V, Wahbi O, et al. Efficiency gains from a standardised approach to older people presenting to the emergency department after a fall. Aust Health Rev. 2020;44(4):576–81.
pubmed: 32600521
doi: 10.1071/AH19187
Desy PM, Prohaska TR. The Geriatric Emergency Nursing Education (GENE) course: an evaluation. J Emerg Nurs. 2008;34(5):396–402.
pubmed: 18804711
doi: 10.1016/j.jen.2007.08.023
Stevens M, Hastings SN, Markland AD, Hwang U, Hung W, Vandenberg AE, et al. Enhancing Quality of Provider Practices for Older Adults in the Emergency Department (EQUiPPED). J Am Geriatr Soc. 2017;65(7):1609–14.
pubmed: 28388818
doi: 10.1111/jgs.14890
Vaughan CP, Hwang U, Vandenberg AE, Leong T, Wu D, Stevens MB, et al. Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme. BMJ Open Qual. 2021;10(4):e001369.
pubmed: 34750188
pmcid: 8576471
doi: 10.1136/bmjoq-2021-001369
Liu YL, Chu LL, Su HC, Tsai KT, Kao PH, Chen JF, et al. Impact of Computer-Based and Pharmacist-Assisted Medication Review Initiated in the Emergency Department. J Am Geriatr Soc. 2019;67(11):2298–304.
pubmed: 31335969
doi: 10.1111/jgs.16078
Matz O, Villa L, Lecce C, OlacireguiDague K, Haeger A, Bollheimer LC, et al. Implementation of a telemedicine geriatric co-evaluation in the emergency department: a prospective pilot study. Swiss Med Wkly. 2021;151:w20500.
pubmed: 34000061
doi: 10.4414/smw.2021.20500
Moss JM, Bryan WE 3rd, Wilkerson LM, King HA, Jackson GL, Owenby RK, et al. An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department. J Pharm Pract. 2019;32(2):167–74.
pubmed: 29277130
doi: 10.1177/0897190017747424
Travers B, Jones S, Bastani A, Opsommer M, Beydoun A, Karabon P, et al. Assessing geriatric patients with head injury in the emergency department using the novel level III trauma protocol. Am J Emerg Med. 2021;45:149–53.
pubmed: 33229252
doi: 10.1016/j.ajem.2020.11.027
Rittenhouse K, Rogers A, Clark E, Horst M, Adams W, Bupp K, et al. The ACT Alert: preliminary results of a novel protocol to assess geriatric head trauma patients on anticoagulation. Am Surg. 2015;81(4):408–13.
pubmed: 25831189
doi: 10.1177/000313481508100433
Pelaez CA, Spilman SK, Fuchsen EA, Semmens AD, Sidwell RA. Trauma Response for Elderly Anticoagulated Patients: an initiative to reduce trauma resource utilization in the emergency department. J Trauma Nurs. 2021;28(3):159–65.
pubmed: 33949350
doi: 10.1097/JTN.0000000000000577
Wallace R, Angus LDG, Munnangi S, Shukry S, DiGiacomo JC, Ruotolo C. Improved outcomes following implementation of a multidisciplinary care pathway for elderly hip fractures. Aging Clin Exp Res. 2019;31(2):273–8.
pubmed: 29687304
doi: 10.1007/s40520-018-0952-7
van der Zwaard BC, Stein CE, Bootsma JEM, van Geffen H, Douw CM, Keijsers C. Fewer patients undergo surgery when adding a comprehensive geriatric assessment in older patients with a hip fracture. Arch Orthop Trauma Surg. 2020;140(4):487–92.
pubmed: 31664575
doi: 10.1007/s00402-019-03294-5
Wright PN, Tan G, Iliffe S, Lee D. The impact of a new emergency admission avoidance system for older people on length of stay and same-day discharges. Age Ageing. 2014;43(1):116–21.
pubmed: 23907007
doi: 10.1093/ageing/aft086
Wiles LL, Day MD. Delta Alert: Expanding Gerotrauma Criteria to Improve Patient Outcomes: A 2-Year Study. J Trauma Nurs. 2018;25(3):159–64.
pubmed: 29742626
doi: 10.1097/JTN.0000000000000371
Hammer PM, Storey AC, Bell T, Bayt D, Hockaday MS, Zarzaur BL Jr, et al. Improving geriatric trauma outcomes: a small step toward a big problem. J Trauma Acute Care Surg. 2016;81(1):162–7.
pubmed: 27032005
doi: 10.1097/TA.0000000000001063
Fernandez FB, Ong A, Martin AP, Schwab CW, Wasser T, Butts CA, et al. Success Of An Expedited Emergency Department Triage Evaluation System For Geriatric Trauma Patients Not Meeting Trauma Activation Criteria. Open Access Emerg Med. 2019;11:241–7.
pubmed: 31754315
pmcid: 6825467
doi: 10.2147/OAEM.S212617
Carr BW, Hammer PM, Timsina L, Rozycki G, Feliciano DV, Coleman JJ. Increased trauma activation is not equally beneficial for all elderly trauma patients. J Trauma Acute Care Surg. 2018;85(3):598–602.
pubmed: 29787528
doi: 10.1097/TA.0000000000001986
Callahan ZM, Gadomski SP 2nd, Koganti D, Patel PH, Beekley AC, Williams P, et al. Geriatric patients on antithrombotic therapy as a criterion for trauma team activation leads to over triage. Am J Surg. 2020;219(1):43–8.
pubmed: 31030991
doi: 10.1016/j.amjsurg.2019.04.011
Keyes M, Alley A, Muertos K, Anderson B, Howerton S, Burns A, et al. The “Headstrike” Protocol: A Retrospective Review of a Single Trauma Center’s Operational Change in the Management of Anticoagulated Ground-Level Falls. Am Surg. 2019;85(8):821–9.
pubmed: 31560301
doi: 10.1177/000313481908500831
Austin E, Blakely B, Salmon P, Braithwaite J, Clay-Williams R. Identifying Constraints on Everyday Clinical Practice: Applying Work Domain Analysis to Emergency Department Care. Hum Factors. 2022;64(1):74–98.
pubmed: 33715488
doi: 10.1177/0018720821995668
Austin E, Blakely B, Salmon P, Braithwaite J, Clay-Williams R. The scope for adaptive capacity in emergency departments: modelling performance constraints using control task analysis and social organisational cooperation analysis. Ergon. 2022;65(3):467–84.
Adams C, Walsan R, McDonnell R, Schembri A. As loud as a construction site: Noise levels in the emergency department. Australas Emerg Care. 2023.
Zia A, Kamaruzzaman SB, Tan MP. Polypharmacy and falls in older people: Balancing evidence-based medicine against falls risk. Postgrad Med. 2015;127(3):330–7.
pubmed: 25539567
doi: 10.1080/00325481.2014.996112
International Consortium for Health Outcomes Measurement. Patient-Centred Outcome Measures USA: ICHOM; 2023. Available from: https://www.ichom.org/patient-centered-outcome-measures/ . [Cited 30 September 2023].
Johnston A, Abraham L, Greenslade J, Thom O, Carlstrom E, Wallis M, et al. Review article: Staff perception of the emergency department working environment: Integrative review of the literature. Emerg Med Australas. 2016;28(1):7–26.
pubmed: 26784282
pmcid: 4755193
doi: 10.1111/1742-6723.12522
Xu H, Kynoch K, Tuckett A, Eley R. Effectiveness of interventions to reduce emergency department staff occupational stress and/or burnout: a systematic review. JBI Evidence Synthesis. 2020;18(6):1156–88.
pubmed: 32813371
doi: 10.11124/JBISRIR-D-19-00252
Weigl M, Schneider A. Associations of work characteristics, employee strain and self-perceived quality of care in Emergency Departments: A cross-sectional study. Int Emerg Nurs. 2017;30:20–4.
pubmed: 27524107
doi: 10.1016/j.ienj.2016.07.002
Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS ONE. 2016;11(7):e0159015.
pubmed: 27391946
pmcid: 4938539
doi: 10.1371/journal.pone.0159015
Coles E, Anderson J, Maxwell M, Harris FM, Gray NM, Milner G, et al. The influence of contextual factors on healthcare quality improvement initiatives: a realist review. Syst Rev. 2020;9(1):94.
pubmed: 32336290
pmcid: 7184709
doi: 10.1186/s13643-020-01344-3
Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ : British Medical Journal. 2014;348:g1687.
pubmed: 24609605
doi: 10.1136/bmj.g1687