Health Affairs: The Journey Of Geriatric Emergency Medicine: Acceleration, Diffusion, And Collaboration As Keys To Continued Growth


 

 

 

By Kelly KoAdriane LesserKevin BieseUla Hwang, and Christopher Carpenter

As more and more of us live longer and healthier lives, we are becoming part of one of the largest demographic shifts in US history, as some 10,000 Americans now turn 65 every day. Innovations in health and care have helped make that increased longevity possible, and now a new wave of innovations to our health care system and community-based services must emerge to reflect our country’s changing demographic. One of these innovations is already occurring within emergency departments (EDs), which are increasingly becoming our nation’s “front porch” of health care for older adults. One out of every two older adults makes an ED visit annually, a large proportion of which result in hospital admission. As more Americans approach that “front porch,” the opportunity to ensure that EDs are delivering care tailored to the needs of older adults has never been greater.

In response, EDs need access to the wealth of research and innovation on senior-appropriate acute care, and with more than 5,000 EDs operating across the United States that is no small feat. The diffusion of innovations theory, which has a long history in the social sciences, helps explain how, why, and at what rate new ideas and technology can spread. While not without its critics, the theory remains widely recognized and has been applied to a variety of real-world challenges, including health care. At its core, the theory relies on three basic principles central to successful adoption of innovations: First is the perception of the innovation, notably the perceived benefit of change. Second are the characteristics driving those who adopt innovation (or fail to do so). And third, contextual factors such as communication, incentives, and leadership also encourage or potentially discourage how innovations get disseminated.

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