A Geriatric Emergency Medicine Assessment Team Reduces Hospital Length of Stay through Faster Discharge to Subacute

Document Type

Conference Proceeding

Publication Date

10-2022

Publication Title

Annals of Emergency Medicine

Abstract

Background Patients aged 65 years of older are more likely to have longer hospital length of stays (LOS) than younger patients. Previously, we described the implementation of a Geriatric Emergency Medicine Assessment (GEMA) team that assesses older adults in the emergency department (ED) and provides appropriate interventions. In a pre-post study, we found that GEMA assessment was associated with a 25- hour reduction in hospital LOS. Study Objectives Using a case-control design on data collected from the first two years after implementation, we sought to quantify the reduction in hospital LOS and further elucidate the causes of this reduced time in the hospital. Methods Our GEMA team consists of an advance practice provider who screens ED patients ≥65 years old for functional decline. If patients screen positive, additional assessments are performed, which can trigger interventions such as occupational therapy (OT) assessment in the ED. Here, we performed a nested case- control study from a larger cohort of patients consisting of all patients ≥65 years of age who presented to the ED between October 2019 and December 2021 and who were subsequently admitted to the hospital (n=34,412). Patients who were admitted to the intensive care unit or to the observation unit were excluded. Cases were designated as those patients who underwent GEMA assessment. Controls were patients who were not assessed by the GEMA team and were matched to cases in a 1:4 ratio, with replacement, based on the criteria age, sex, race, and Estimated Severity Index (ESI). Data was obtained by retrospective chart review. Results: There were 3,019 cases and 8,379 controls. The mean hospital LOS was 23 hours shorter for cases compared to controls (5.74 d vs 6.69 d; p

Volume

80

Issue

4S

First Page

S132

DOI

10.1016/j.annemergmed.2022.08.336

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