332 GEMS: Geriatric Emergency Service - Outputs and Outcomes from the Acute Floor Team

Autor:	Jane Nolan, Emer Ahern, Danielle Reddy, Ann Mulholland, Maureen O’Callaghan, Lorna Cornally, Cathriona Normoyle, Grainne Gallagher, Ruth Gibbons, Megan Hayes Brennan
Rok vydání:	2019
Předmět:	Geriatrics Service (business) Polypharmacy Aging medicine.medical_specialty business.industry General Medicine Hospital mortality medicine.disease Triage Malnutrition medicine Delirium Medical emergency Geriatrics and Gerontology medicine.symptom business
Zdroj:	Age and Ageing. 48:iii17-iii65
ISSN:	1468-2834 0002-0729
Popis:	Background Frailty is now a key concept in healthcare planning and delivery and is driving vertical and horizontal integration. The positive narrative of Frailty is further emphasised by the growing scientific evidence in the prevention, reversal and modification of Frailty. Early identification of Frailty and early intervention with Comprehensive Geriatric Assessment (CGA) is fundamental. Older people with Frailty admitted to hospital who receive a CGA early are more likely to return home. Benefits are seen early and are sustained (Ellis et al 2011). Methods The aim of GEMS is to improve care, outcomes and the patient experience for older people living with Frailty. All people aged 75 years and older who attend as an emergency are screened on triage using the Variable Indicative of Placement Tool (VIP). Screening is automatic and mandatory. The GEMS Acute Floor Team respond early to those who screen positive by starting a CGA. The GEMS Home Team case manage those who are admitted. Results Over 2 years 10,037 patients were triaged. The median time from arrival to VIP was 15 minutes. 43% screened positive for Frailty. 66% received a CGA. The median time from VIP to CGA was 1.7 hours. 84% identified at risk of polypharmacy, 27% at risk of malnutrition, 29% with delirium. 74% were admitted from home. 78% returned to pre-admission residence. 4% new admissions to NH care. Median length of stay was 7 days. The readmission rate within 30 days was 16%. 7% in hospital mortality. Conclusion The GEMS Team have developed and delivered a pioneering integrated care approach to the management of older person at high risk of adverse outcomes attending the acute floor.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::e6180faf71906f284f08e6b9782e39ec https://doi.org/10.1093/ageing/afz103.215 Zobrazit plný text záznamu