Medical groups issue new geriatric ER guidelines

Four medical groups issued new standardized geriatric emergency care guidelines that outline how to set up programs and deliver care to this growing population.

The guidelines, developed by the American College of Emergency Physicians (ACEP), the American Geriatrics Society (AGS), the Emergency Nurses Association and the Society for Academic Emergency Medicine, address various problems common in aging patients, including delirium, falls, medication management, catheter use and dementia.

"Geriatric emergency departments first appeared in 2008, but this is the first time there has been a standardized template for how they should be set up and how care for older patients should be delivered," said ACEP President Alex Rosenau in a statement.  "It is important that the special needs of these vulnerable patients are met appropriately in the emergency setting. As of 2010, there were 40 million people in this age group, and many of them will be emergency patients at some point."

The four groups fine-tuned the guidelines over the past two years in response to the aging population and its effect on healthcare costs. Geriatric emergency department (ED) patients account for 43 percent of all hospital admissions, and they tend to have longer ED stays and use more resources, according to the statement. Similar programs targeted at specific age groups, such as pediatrics, and conditions like strokes or trauma, resulted in improvement of care at the individual emergency room (ER) and system-wide level, according to the statement.

"Our advice to healthcare systems with limited resources is to make the entire emergency department a geriatric emergency department," said Mark Rosenberg, D.O., geriatric emergency medicine chief at St. Joseph's Healthcare System in Paterson, N.J., and chair of ACEP's task force for geriatric ED guidelines. "If the ER is designed for the most frail and vulnerable, it will work for the strongest patients as well."

There are currently about 50 geriatric ERs operating nationwide, with another 150 in development, and older adults make up 25 percent of ER visitors, FierceHealthcare previously reported.

To learn more:
- read the guidelines (.pdf)
- here's the statement