Volunteer contributions in the emergency department: A scoping review

The objective of this scoping review was to identify published and unpublished reports that described volunteer programs in the emergency department (ED) and determine how these programs impacted patient experiences or outcomes. Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were conducted and reference lists were hand-searched. A grey literature search was also conducted. Two reviewers independently screened titles and abstracts, reviewed full text articles, and extracted data. The search strategy yielded 4,589 potentially relevant citations; 87 reports were included in the review. Volunteer activities were categorized as non-clinical tasks (e.g., provision of meals/snacks, comfort items and mobility assistance), navigation, emotional support/communication, and administrative duties. 52 (59.8%) programs had general volunteers in the ED and 35 (40.2%) had volunteers targeting a specific patient population, including pediatrics, geriatrics, patients with mental health and addiction issues and other vulnerable populations. 18 (20.6%) programs included an evaluative component describing how ED volunteers affected patient experiences and outcomes. Patient satisfaction, follow-up and referral rates, ED hospital costs and length of stay, subsequent ED visits, medical complications, and malnutrition in the hospital were all reported to be positively affected by volunteers in the ED. These findings demonstrate the important role volunteers play in enhancing patient and caregiver experience in the ED. Future volunteer engagement programs should be formally described and evaluated to share their success and experience with others interested in implementing similar programs in the ED. Experience Framework This article is associated with the Infrastructure & Governance lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients.

In December 2017, the National Academy of Neuropsychology convened an interorganizational Summit on Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients in Denver, Colorado. The Summit brought together representatives of a broad range of stakeholders invested in the care of older adults to focus on the topic of cognitive health and aging. Summit participants specifically examined questions of who should be screened for cognitive impairment and how they should be screened in medical settings. This is important in the context of an acute illness given that the presence of cognitive impairment can have significant implications for care and for the management of concomitant diseases as well as pose a major risk factor for dementia. Participants arrived at general principles to guide future screening approaches in medical populations and identified knowledge gaps to direct future research. Key learning points of the summit included: recognizing the importance of educating patients and healthcare providers about the value of assessing current and baseline cognition;emphasizing that any screening tool must be appropriately normalized and validated in the population in which it is used to obtain accurate information, including considerations of language, cultural factors, and education; andrecognizing the great potential, with appropriate caveats, of electronic health records to augment cognitive screening and tracking of changes in cognitive health over time

An approach to the older patient in the emergency department

Older patients in the emergency department (ED) present unique diagnostic and therapeutic challenges. The ED clinicians must simultaneously evaluate and treat older adults along multiple domains: cognitive impairment, atypical presentations, functional impairment, medication management, trauma and falls, and end-of-life care. This article reviews these domains and suggests strategies for a more comprehensive, patient-centered ED approach to older patients. Incorporating assessment of these domains into the ED process improves patient outcomes, provider satisfaction, and ED flow

Statement on Minimum Standards for the Care of Older People in Emergency Departments by the Geriatric Emergency Medicine Special Interest Group of the International Federation for Emergency Medicine

Pathophysiology, epidemiology and therapy of agein

Statement on minimum standards for the care of older people in emergency departments by the geriatric emergency medicine special interest group of the international federation for emergency medicine

Pathophysiology, epidemiology and therapy of agein