June 21, 2019
By Nicole Tidwel, Geriatric Emergency Department Accreditation Program Director, American College of Emergency Physicians
You care for this patient every shift. An older person with multiple medical problems who is trying to live at home. Are they normally slightly confused? Does laying in bed for 6 hours in the ED during your work up do them any harm? Are they safe to return to home? What resources do they need? These are the issues that EM physicians and nurses struggle with every day, and the reasons why the Geriatric Emergency Department concept was developed.
Older adults account for 46% of all ED visits resulting in hospitalization1. Approximately one out of every 10 hospital admissions are potentially avoidable, and the majority (60%) of those admissions are for patients 65+2.
EDs around the country which are focused on improving their care of older patients can become accredited through the American College of Emergency Physicians (ACEP) as a Geriatric (appropriate) ED with ACEP’s Geriatric Emergency Department Accreditation program (GEDA.) The accreditation is the first of its kind and is part of an effort to improve the quality and standards of emergency care provided to the nation’s older patients. The program builds upon the foundational work and support of the Gary and Mary West Health Institute and The John A. Hartford Foundation to enhance geriatric emergency care across the country.
The geriatric ED accreditation process follows a series of related efforts. In 2013, ACEP, alongside three other major medical professional associations vested in geriatric care, released the Geriatric Emergency Department Guidelines, the product of two years of consensus-based work that specify broad domains and recommends measures ranging from adding geriatric-friendly equipment to geriatric-focused staff to more routine screening for delirium, dementia, falls, and more.