Mixed methods study of the Geriatric Emergency Department Intervention (GEDI)

The effect of a GEDI program on outcomes for elderly residential care facility residents presenting to a regional emergency department

Grant ID: EMRS-61R29-2018

Project Summary

As the population of Australia grows the percentage of those aged >65years is expected to double over the next 30 years. This will lead to more patients presenting to emergency of which a significantly larger portion will be frail and/or from residential care facilities (RCF). This vulnerable population is at significant risk of hospital acquired complications including acute confusion, falls, and infections if they suffer prolonged stays in the emergency department (ED) or on admission to hospital.

The GEDI program is an innovative nurse led intervention designed to improve emergency care of frail older persons who develop an acute medical problem. GEDI's are trained in geriatrics and have excellent communication skills liaising with RCF staff, families, general practitioners, ED medical officers/nurses and inpatient teams. Their role also involves patient centred geriatric risk assessment and management to minimise the negative impact of the older person’s emergency visit. The program has already been shown to led to a decrease in ED and hospital length of stay, improved patient and staff satisfaction and decrease in overall cost of care.

In this research project, we will evaluate the structures, processes and outcomes of the GEDI intervention relevant to the RCF cohort. This study will look specifically at the RCF dwelling cohort as they have often been excluded from previous studies. We hope to use the outcomes of this research to gain a greater understanding of the problems faced by our frail ED RCF population and with this knowledge develop innovative evidenced based healthcare solutions.

Dissemination

Marsden, E.J., Taylor, A., Wallis, M., Craswell, A., Broadbent, M., Johnston-Devin, C. and Crilly, J., 2021. A structure and process evaluation of the Geriatric Emergency Department Intervention model. Australasian Emergency Care, 24(1), pp.28-33.

Marsden, E., Taylor, A., Wallis, M., Craswell, A., Broadbent, M., Barnett, A. and Crilly, J., 2020. Effect of the Geriatric Emergency Department Intervention on outcomes of care for residents of aged care facilities: A non‐randomised trial. Emergency Medicine Australasia, 32(3), pp.422-429.