Teamwork the best option for elderly patients in ER
THE unique Geriatric Emergency Department Intervention program, which was conceived and tested in a small hospital in regional Queensland, has the potential to go worldwide.
GEDI is a fast-track hospital emergency department program designed specifically for frail elderly patients, mostly aged about 70 and over.
University of the Sunshine Coast GEDI research leader and program co-designer Professor Marianne Wallis said: “If you are increasingly frail, maybe with some mild cognitive impairment or some other agerelated condition, then emergency departments become very confusing places – there are bright lights, noise, machines going ping.”
What these patients need is for someone to work out what care is required for the patient. This is where GEDI comes to the fore.
A team of gerontologyskilled ED nurses, dressed in bright and easily identifiable pink uniforms, are on hand.
Attached to the team is an ED doctor who acts as the medical lead and communicates with other doctors on the GEDI patient’s needs.
Where the service starts is when a frail person arrives at the ED. The primary ED nurse will call in a GEDI nurse to review an admitting patient.
“Those nurses are specially equipped to make detailed assessments of frailty and particular issues that relate to older people,” Prof Wallis said.
“They then have direct referral pathways such as straight through to the orthopedic surgeon or the aged care team or to community services if the GEDI nurse believes the patient would be better looked after by that group.
“The GEDI nurses can organise for people to be safely transported back home and put in place better care.”
With the appropriate care at home these people then avoid the stresses of medication and routine changes, disorientation and confusion – all of which can happen when an elderly person is pushed to the ED.
The GEDI program outcomes will help to reduce the number of people unnecessarily admitted to hospital and provide a higher level of care for elderly patients.
The innovative program is in place in two Sunshine Coast hospitals. It will next be rolled out at Cairns Base Hospital and Ipswich Hospital.
From there an implementation training program will be developed before GEDI is offered to hospitals Australiawide.