WASHINGTON, D.C.—The American College of Emergency Physicians (ACEP) has launched its new Geriatric Emergency Department Accreditation (GEDA) program. The program is part of an effort to improve and standardize emergency care for the nation's older patients and builds on the financial support and foundational work of the Gary and Mary West Health Institute and The John A. Hartford Foundation.
"Older adults visit emergency departments at a high rate, they often present with multiple chronic conditions and face more social and physical challenges than the general population," said Paul Kivela, MD, MBA, FACEP, president of ACEP. "Seniors who visit ACEP accredited emergency departments can be assured that the facilities have the necessary expertise, equipment and personnel in place to provide optimal care. This initiative will greatly enhance geriatric emergency care, especially in rural areas, and help ease older patients back into their daily lives after an emergency occurs."
The GEDA program promotes the goals of providing quality care for older adult patients. These include enhanced staffing and education and geriatric-focused policies and protocols, including transitions of care, quality improvement and outcomes and more efficient preparation of the treatment area.
Kevin Biese, MD, FACEP, will manage the project. The launch of the accreditation program follows the creation of geriatric emergency department guidelines by ACEP and other medical groups that went into effect in 2014.
"The nation's emergency departments operate more like care transition hubs," said Dr. Biese in an interview featured in Annals of Emergency Medicine. "In addition to treating acute conditions, emergency physicians have a unique opportunity to develop a more comprehensive approach to caring for older patients; reviewing and flagging concerns that help reduce future hospital stays and assisting with care transitions."
Approximately 60 percent of Medicare patients admitted to the hospital arrive through the emergency department, according to 2013 RANDresearch. Multiple studies in Annals of Emergency Medicine note the vulnerability of older adults after an emergency visit.
"There is a tremendous opportunity to better address the needs of the 20 million seniors who visit our nation's emergency departments annually," said Shelley Lyford, president and CEO of the West Health Institute. "We're proud to partner with ACEP on the nation's first initiative to help standardize the quality of emergency care for older adults across the country. We're very pleased that the Gary and Mary West Emergency Department at UC San Diego Health is leading the way in California as the first in the state to be accredited by ACEP in recognition of its commitment to delivering high-quality, geriatric care."
The voluntary accreditation includes three levels (similar to trauma designations) with specific criteria and goals for clinicians and administrators. Requirements begin with demonstrating that the participating emergency department (1) includes both a physician and nurse with specialized geriatric training on staff, (2) meets environmental criteria such as easy patient access to water and mobility aids and (3) has a geriatric quality improvement program.
Hospitals are encouraged to start at the level most appropriate for their institutions and strive to reach higher levels of accreditation over time. Accreditation provides more than two dozen best practices for geriatric care and is now available nationwide. The program will launch to the international market in the next year.
"We have seen a proliferation of so-called 'geriatric' emergency departments over the last several years, and the GEDA program will for the first time provide public assurance that these sites are actually meeting standards that can improve care and outcomes for older adults," said Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation. "We are proud to be a part of the effort."
Eight emergency departments are currently accredited as part of the GEDA pilot program:
- Aurora Medical Center of Oshkosh (WI)
- Aurora Sheboygan Memorial Medical Center (WI)
- Aurora Sinai Medical Center (WI)
- Aurora St. Luke's South Shore Medical Center (WI)
- Aurora West Allis Medical Center (WI)
- The Mount Sinai Hospital (NY)
- St. Joseph's University Medical Center (NJ)
- The Gary and Mary West Emergency Department at University of California, San Diego Health, La Jolla (CA)