• Clin Med · Dec 2013

    Case Reports

    Effectiveness of a geriatrician in the emergency department in facilitating safe admission prevention of older patients.

    • Sally Jones and Peter Wallis.
    • Birmingham Heartlands Hospital, Heart of England Foundation Trust, UK.
    • Clin Med. 2013 Dec 1; 13 (6): 561564561-4.

    AbstractThe decision to admit a frail older patient is rarely made by a geriatrician and often falls to staff in the emergency department (ED), who may not have the training to balance the risks, benefits and alternatives. We based a consultant geriatrician in the ED with the primary aim of facilitating admission prevention for older patients and this was achieved for 64% (543/848) of patients. A secondary aim was to facilitate direct admission to elderly care wards when admission was necessary, and this was achieved for 57% of admitted patients (174/305). The geriatrician was able to facilitate discharge from the ED for over half of potential 30-day readmissions seen. The overall 7-day ED re-attendance rate was 10.1%, but only 3.4% of patients were admitted with the same problem, indicating true admission prevention rather than admission delay. In conclusion, the placement of a consultant geriatrician in the ED is effective in facilitating admission prevention for older patients.

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