Northwestern Memorial Hospital’s geriatric ER program cuts unnecessary admissions by 33%

Patient and nurse in hospital
Northwestern Memorial Hospital's geriatric emergency department innovations program was introduced in 2013. (Getty/monkeybusinessimages)

An emergency department program that focused on geriatric transitional care has significantly reduced the risk of unnecessary admissions of geriatric patients, according to a new study.

Northwestern Memorial Hospital cut the admissions by 33%, according to researchers from Northwestern University, Mount Sinai Medical Center and St. Joseph’s Regional Medical Center. The study findings were published in the Journal of the American Geriatrics Society.

The three hospitals introduced the geriatric emergency department innovations program (GEDI) in 2013 to reduce the need to hospitalize older patients after an emergency department visit and to prevent revisits and readmissions.

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The reduction in hospital risk at St. Joseph’s Regional Medical Center was smaller than the other two hospitals, according to the study. Patients at the New Jersey hospital who were part of the program were admitted 46% of the time. Those who didn’t receive specialized care were admitted 51% of the time.

Mount Sinai Medical Center’s patients who received the specialized care were admitted 36% of the time; those who didn’t receive the specialized care were admitted 46% of the time.

Northwestern had the best results. Patients who received the specialized care were admitted 36% of the time; those who weren’t involved in the program were admitted 53% of the time.

Northwestern staffs the program with a GEDI nurse, a pharmacist and a social worker on weekdays between 9 a.m. and 10 p.m., Northwestern Now reports. Nurses evaluate patients to determine if they are candidates for the program. If so, they are moved to a quiet floor that features rooms with nonglare, nonslip floors, doors and televisions and windows. Nurses also meet with the patients one-on-one to determine what needs they may have at home.

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“With this program, we have created an otherwise nonexistent safety net for this vulnerable population,” Scott Dresden, M.D., co-author on the paper and assistant professor of emergency medicine at Northwestern University Feinberg School of Medicine, told Northwestern Now. “We wanted to ensure that we weren’t just discharging older patients from the emergency department only to be hospitalized again relatively quickly after something preventable like a fall.”

Dresden said that other hospitals can easily adopt the program because there is no need to build a separate space.

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