Objectives: To compare the outcomes of patients seen during a pilot Senior Emergency Department (ED) program to a historical cohort of geriatric patients receiving usual ED care.
Methods: We performed a retrospective cohort analysis of quality assurance data obtained to evaluate the implementation of a pilot Senior ED program at a 78,000 visit hospital ED. The historical cohort covered 1/23/2012 to 12/31/2012. The pilot Senior ED program was implemented from 1/1/2013 to 12/31/2013. Patients 65 years and older arriving between 8:30 am and 8:30 pm were triaged to a 15 bed Senior ED. Interventions included assessment by a nurse transitional care coordinator, care protocols, education, pharmacy review and call backs on discharged patients. Data are presented as means, proportions, differences, and analyzed for statistical significance using the t-test where p\u3c0.05 is considered significant.
Results: There were 12,503 eligible visits in 2012 and 13,627 eligible visits in 2013. The mean age was 78 years in both cohorts; 58% were female in 2012 and 53% in 2013. During the pilot Senior ED program length of stay was increased (2012: 287 minutes vs. 2013: 298 minutes), admissions were significantly decreased (54% vs. 49%, p=0.000), and observation patients increased (2.4% vs. 4.9%, p=0.000). During the pilot Senior ED program, discharges to home increased by 2.7% (p=0.000).
Conclusions: The pilot Senior ED program reduced inpatient admissions, increased observations, and increased discharges to home significantly showing the program’s effectiveness in managing acutely ill senior patients
