Abstract
BackgroundInternational guidelines recommend adapting the classic emergency department (ED) management model to the needs of older adults in order to ameliorate post-ED outcomes among this vulnerable group. To improve the care for older ED patients and especially prevent unplanned ED readmissions, the URGENT care model was developed.MethodsThe URGENT care model is a nurse-led, comprehensive geriatric assessment based care model in the ED with geriatric follow-up after ED discharge. A prospective single centre quasi-experimental study (sequential design with two cohorts) is used to evaluate its effectiveness on unplanned ED readmission compared to usual ED care. Secondary outcome measures are hospitalization rate, ED length of stay, in-hospital length of stay, higher level of care, functional decline and mortality.DiscussionURGENT builds on previous research with adaptations tailored to the local context and addresses the needs of older patients in the ED with a special focus on transition of care. Although the selected approaches have been tested in other settings, evidence on this type of innovative care models in the ED setting is inconclusive.Trial registrationThe study protocol is registered retrospectively with ISRCTN (ISRCTN91449949).
Highlights
International guidelines recommend adapting the classic emergency department (ED) management model to the needs of older adults in order to ameliorate post-ED outcomes among this vulnerable group
Implementing comprehensive geriatric assessment (CGA) in ED care can improve the timely recognition of geriatric problems [8]
The aim of this paper is to describe the protocol of the ‘Unplanned Readmission prevention by Geriatric Emergency Network for Transitional care’ (URGENT) research project
Summary
International guidelines recommend adapting the classic emergency department (ED) management model to the needs of older adults in order to ameliorate post-ED outcomes among this vulnerable group. CGA has been defined as “a multidimensional interdisciplinary diagnostic process focused on determining a frail older person’s medical, psychosocial and functional capabilities in order to develop a coordinated and integrated plan for treatment and long-term follow-up” [11]. This approach has shown a beneficial impact in patients admitted to acute geriatric wards [12,13,14]. The impact of CGA in ED patients remains inconclusive due to heterogeneity in interventions, study designs and ED settings [15,16,17]
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