Data analytics can help in the GEDA accreditation process.
As the retirement-age population continues to grow, geriatric emergency departments are cropping up across the United States to serve elderly patients. According to CDC, ED visits by people over age 65 increased by more than 27% from 2005 to 2015. As of January 2019, there were 23 accredited geriatric EDs in 10 states, and more than 100 had started the application process for accreditation.
The “silver tsunami” of retiring baby boomers is creating a greater need to streamline medical processes. And, there’s a growing awareness that traditional EDs aren’t well suited for older patients. They’re better at treating acute injuries, overdoses, and heart attacks, but seniors tend to seek treatment for injuries caused by falls, and often, they need care for complications from conditions such as diabetes and heart failure.
A geriatric ED is more likely to look at the cause of an emergency and assess an older patient’s everyday risks. And, because even short hospitalizations can have dire consequences for older patients — including mental anguish and hospital-borne infections — one of the goals of a geriatric ED is to prevent unnecessary hospitalization.
To provide a level of standardization across geriatric EDs, the American College of Emergency Physicians (ACEP) has developed a Geriatric Emergency Department Accreditation (GEDA). It’s not necessary to create a separate ED to be accredited. The ED must follow specific guidelines, for instance, using screening tools for dementia and employing geriatric specialists.
Although the guidelines have existed since 2014, the GEDA program went into effect in 2018. As with trauma center accreditations, there are three levels of ACEP accreditation. Level 1 is the most comprehensive designation. Levels 2 and 3 don’t have as many reporting requirements and other guidelines but require a facility to provide at least some services geared toward older patients and to employ at least some geriatric-trained nurses and physicians.
For Level 1, ACEP conducts on-site visits and requires reporting and tracking of at least five outcome measures, such as the number of patients who stay longer than eight hours and the number of repeat visits by seniors.
St. Joseph’s Success
The 20-bed wing of St. Joseph’s University Medical Center in Paterson, New Jersey, was one of the first geriatric EDs in the U.S. to be accredited as a Level 1 geriatric ED under ACEP’s GEDA program. When it opened in 2009, there were no industry guidelines, so it relied on patient feedback and recommendations to build its services. The geriatric ED is part of a larger, common-purpose ED — one of the largest and busiest in the U.S. — but has more privacy and less noise.
St. Joseph’s provides a staff trained in geriatric medicine, including nurses and physicians. Upon admission, all patients are screened for risk of falling, depression, dementia, and delirium, and undergo a medication review. After-care includes a follow-up appointment with the patient’s primary physician, as well as phone calls to make sure patients are taking their medications.
Goals include wait times of less than 15 minutes and total stays of no more than four hours. Dr. Mark Rosenberg, chair of emergency medicine at St. Joseph’s Health, said that the geriatric ED has reduced inpatient admissions to about 34%, down from 54% when it opened. He also noted that patient satisfaction in the geriatric ED is higher than anywhere else in the ED.
How d2i Has Helped
While a significant commitment of staff and space was required for accreditation, St. Joseph’s also depended on d2i’s Performance Analytics Application to track outcome measures required for accreditation. Geriatric EDs must track at least five of 20 statistics, which may include:
- Number of seniors admitted to the hospital, by diagnosis and chief complaint
- Number and percentage of seniors with a LOS greater than 8 hours
- Percentage of eligible positively screened patients who are appropriately referred based on set guidelines
To assist hospitals in the application process, our advanced analytics solutions help with planning, implementation, and assessment of treatment protocols and geriatric-specific quality initiatives. These can include standardizing falls risk assessment, managing pain control for elder patients, establishing a dementia screening process, and so much more.
If your hospital’s geriatric ED is preparing for ACEP’s Geriatric ED accreditation program, d2i can help you measure required outcomes and promote quality initiatives designed for senior patients. Contact our team to learn about all of the ways our software can help you improve performance, or to schedule a 30-minute demo.