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Managing older patients safely in the time critical environment of an emergency department

Hong Kong Journal of Emergency Medicine
Volume 19 Issue 4 (July 2012)

Abstract: Demand for emergency department (ED) services is increasing worldwide. The fastest growth in ED presentations is by patients aged >=65 years, currently representing 18% of all attendances. Older patients present with more complex clinical conditions and multiple co-morbidities. This means they are likely to spend more time in ED, are more likely to be admitted to hospital, and are more likely to re-attend. The Safe Elderly Emergency Discharge (SEED) project aims to determine whether current models of emergency care ensure safe discharge and facilitate optimal health outcomes for older patients; and develop a tailored evidencebased care framework applicable to Australian and international settings. Risk screening for unsafe discharge will be conducted on patients aged >=65 years discharged home from ED. Patients will be followed for 6 months post-ED presentation to monitor health outcomes and map their care journey. Demographic, clinical, and functional characteristics will be collected. The primary outcome is unsafe discharge, defined as unplanned re-presentation/admission within 30 days of the index presentation. Secondary outcomes include unplanned ED re-presentation/hospital admission within 6 months; patient experience; change in functional status; functional decline; health service utilisation; and death within 6 months. The effectiveness of the ED discharge risk screening tools for predicting unsafe discharge will be evaluated at 30 days and 6 months. SEED will determine the risk factors for unplanned ED re-presentation/hospital admission at 30 days for patients aged >=65 years presenting to ED; which will inform the development of an evidence-based older patient care framework for EDs.

To cite this article: Lowthian, JA; Brand, C; Barker, AL; Andrianopoulos, N; Smith, C; Batey, C; Smit, PDe V; Newnham, HH; Hunter, P and Cameron, PA. Managing older patients safely in the time critical environment of an emergency department [online]. Hong Kong Journal of Emergency Medicine, Vol. 19, No. 4, July 2012: 264-271. Availability: <http://search.informit.com.au/documentSummary;dn=579270052679932;res=IELHEA> ISSN: 1024-9079. [cited 28 Jun 17].

Personal Author: Lowthian, JA; Brand, C; Barker, AL; Andrianopoulos, N; Smith, C; Batey, C; Smit, PDe V; Newnham, HH; Hunter, P; Cameron, PA; Source: Hong Kong Journal of Emergency Medicine, Vol. 19, No. 4, July 2012: 264-271 DOI: Document Type: Journal Article ISSN: 1024-9079 Subject: Emergency medicine; Clinical medicine; Health risk assessment; Outcome assessment (Medical care); Evidence-based medicine; Peer Reviewed: Yes Affiliation: (1) Monash University, Centre of Research Excellence in Patient Safety, Australia, email: Judy.Lowthian@monash.edu
(2) Alfred Health, Alfred Emergency and Trauma Centre, Melbourne, Australia
(3) Alfred Health, Alfred Emergency and Trauma Centre, Melbourne, Australia
(4) Alfred Health, Alfred Emergency and Trauma Centre, Melbourne, Australia
(5) Alfred Health, General Medicine, Melbourne, Australia
(6) Alfred Health, Aged and Community Care, Melbourne, Australia

Database: Health Collection