• Tara Liberman, Regina Roofeh, Natalie Sohn, Martina Brave, Alison Smith, Helena Willis, Robert Silverman, and Nancy Kwon.
• Long Island Jewish Medical Center, Northwell Health, New Hyde Park, New York.
• J Emerg Med. 2020 Feb 1; 58 (2): 191-197.

BackgroundOlder adults presenting to the emergency department (ED) represent a highly vulnerable patient population with complex conditions and multiple comorbidities. The introduction of a Geriatric and Palliative (GAP)-ED partnership may be an effective strategy to avoid unneeded admissions and improve outcomes for this population.ObjectivesThe primary objective was to decrease 30-day revisit and hospitalization rates in this population through identifying patients that could be safely sent home with connection to community resources. Secondary outcomes included achieving high patient and family satisfaction scores assessed through follow-up interviews.MethodsThe GAP-ED intervention included the placement of a Specialist in the ED to coordinate care for older adults presenting to the ED who were likely to be discharged home. Independent t-tests and chi-squared tests were used to assess for changes in outcomes between the intervention group and a blocked matched historical usual-care group.ResultsThere was no significant difference in 30-day ED revisits between the two groups, but there was a statistically significant reduction in hospital admissions from these 30-day revisits. Patient and family satisfaction with the presence of the GAP-ED Specialist was high.ConclusionThe implementation of a GAP-ED partnership and use of a GAP-ED Specialist is an effective means of reducing hospitalization in older adults revisiting the ED.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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