• Caitlin Meechan, Navena Navaneetharaja, Sarah Bailey, Rachel Burridge, Martyn Patel, Yoon K Loke, and Katharina Mattishent.
• Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
• J Emerg Med. 2023 Jul 1; 65 (1): e50e59e50-e59.

BackgroundThe complexity of older patients along with trends in poorer outcomes in the emergency department (ED) has prompted research into how EDs can adapt to meet the needs of an aging population. A separate Older People's Emergency Department (OPED) has been proposed to improve care at the front door.ObjectiveCompare patient flow in a dedicated OPED at a University Hospital in Norfolk, United Kingdom, against that of the main ED.MethodsWe carried out a retrospective cohort study to compare older patients attending the ED in 2019 against those attending the newly formed OPED service in 2020. Multivariable logistic regression was performed to estimate adjusted odds ratios (emergency admissions, meeting England's 4-h national target, re-admissions, all-cause 30-day mortality, clinical frailty screening, and discharge to original place of residence).ResultsClinical assessment in the OPED did not significantly lower the proportion of patients admitted to the hospital (adjusted odds ratio 0.84; 95% confidence interval 0.61-1.16).  There were significant reductions in overall time spent in the department, time to initial clinician review, and time to frailty screening. Patients seen in the OPED were more likely to meet the national 4-h target and more likely to be discharged to their original place of residence.ConclusionsAssessment in the OPED was not associated with a significantly reduced likelihood of hospitalization. However, patients had a shorter wait for clinical assessment, with concomitant reduction in department length of stay.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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