A public health/hospital partnership to improve Emergency Department transitions of care for vulnerable older adults.

Autor: Southerland LT; Department of Emergency Medicine, The Ohio State University, Columbus, Ohio, USA., Dixon C; Case Management and Social Work, The Ohio State University East Hospital, Columbus, Ohio, USA., Turner S; Franklin County Office on Aging, Columbus, Ohio, USA., West KM; Franklin County Office on Aging, Columbus, Ohio, USA., Hairston T; Case Management and Social Work, The Ohio State University East Hospital, Columbus, Ohio, USA., Rosen T; Department of Emergency Medicine, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA., Rankin C; Franklin County Office on Aging, Columbus, Ohio, USA.
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2024 Oct 17. Date of Electronic Publication: 2024 Oct 17.
DOI: 10.1111/jgs.19227
Abstrakt: Background: Community-dwelling older adults are at high risk for unmet social service needs. We describe a novel partnership embedding county services case managers in the Emergency Department (ED) to connect older adults to community services alongside their medical care.
Methods: Setting: A medium-sized urban ED with 55,000 patient visits a year.
Intervention: Case managers from the Franklin County, Ohio Office on Aging (OA) were embedded within the ED. The OA team worked with the ED social work team to identify community-dwelling older patients, perform an in-person intake assessment, and initiate needed community services (including home-delivered meals, emergency response systems, house repairs, and transportation). Program logic model and development are reported in detail.
Results: From June to December 2023, there were 7284 ED visits for adults ≥60 years old. Referrals to the OA case manager ranged from 1 to 13 per day. The OA case managers performed 252 full intake assessments on unique patients. The population was 51% men. Only 11% (n = 28) were currently connected to OA services, and of those already connected 29% (n = 8) needed increased services. Of the remaining unconnected patients (n = 224), 8% (n = 20) were not county residents and the OA team connected them with other county OAs. Half 53% (n = 120) were accepting of services and had services from the OA or other community health programs initiated during the ED visit. The OA team made three new Adult Protective Services referrals and one referral to the long-term care ombudsman. The program did not increase ED length of stay or hospital admission rates.
Conclusions: Embedding county service enrollment within a community ED is a cost neutral intervention that reached a population without previous services. Future plans include expansion of the program and evaluation of the program's ability to detect elder mistreatment and self-neglect.
(© 2024 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
Databáze: MEDLINE
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