A geriatric ED may be either a separate space designated for older adults, or more likely, the integration of best practices for older adults into an existing ED. It includes:
Additional resources equipment (eg, food, chairs, mobility aids, hearing assists, clocks, enhanced lighting) and enhanced strategies for transitions of care for older patients into and out of the ED.
The Geriatric Emergency Department Accreditation (GEDA) program is an ACEP-governed national accreditation organization which strives to improve the care of older people presenting to the emergency department. This accreditation system promotes the goals quality of care for older people: enhanced staffing and education; geriatric-focused policies and protocols including transitions of care; quality improvement and metrics; and optimal preparation of the physical environment.
Three levels of accreditation with increasing requirements are available. Level 3 is within reach of every hospital. With a little more effort and dedication to quality care for seniors, Level 2 and Level 1 can be reached. Hospitals will start at the level that is most appropriate for their current resources and strive to reach a higher level over time.
The program was developed by leaders within the ACEP Geriatric Emergency Medicine Section with the support of the ACEP Board of Directors. The leaders within GEDA were appointed by the ACEP Board of Directors to the GEDA Board of Governors. The Board of Governors consist of national and international leaders in geriatric emergency medicine.
Becoming a geriatric ED will improve the care provided to older people in your ED, will ensure the resources to provide that care are available, and signal to the public that your institution is focused on the highest standards for providing care to your community’s older citizens.
Accreditation is an excellent way to convey to your patients, colleagues, and community that your ED cares about the service they provide to older patients. Today, 20 million seniors visit our nation’s EDs. With the number of older adults growing rapidly, there is a critical need for more geriatric-focused care. Preparing for accreditation allows the hospital and ED to focus on the needs of this complex and growing population and to ensure that the resources available to the ED meet the needs of the patients they serve.
Early data from existing models of geriatric emergency care – models that promote best clinical practices and create a more positive and sensitive physical environment – show they have the potential to improve health outcomes, coordinate care more effectively, and reduce costs.
The following criteria outline the minimum standards for accreditation of a Geriatric Emergency Department in three levels.
Level 3 accreditation is represented by one or more geriatric-specific initiatives that are reasonably expected to elevate the level of elder care in one or more specific areas. Additionally, personnel to implement these efforts are identified and trained.
Level 2 accreditation identifies sites that have integrated older adult initiatives into daily operations. They demonstrate interdisciplinary cooperation for delivery of senior-friendly services. They have an established supervisor or director coordinating the people who are tasked with the daily performance of these services.
Level 1 accreditation defines an ED with a comprehensive care system in place for improving the care of older adults, including but not limited to: senior-specific policies, guidelines, procedures, interdisciplinary staff (both within the ED and throughout the institution), outcome measurements and evaluation efforts. Additionally, they may have physical facility enhancements designed to improve older adult care.
This guide book contains several chapters relevant to accreditation: Creating a Geriatric Emergency Department, published by Cambridge University Press, is available from Amazon.
Accreditation lasts three years.
Yes. If an applicant will be submitting more than one application from the same health system, please contact Nicole Tidwell at ntidwell@acep.org for instructions on how to easily submit multiple applications.
Once you have submitted a completed application, it will be reviewed by two ACEP-appointed expert geriatric emergency physicians. You may be asked additional questions to clarify parts of your application. If you are applying for a Level 1 geriatric ED, a one-day site visit will be required. If you are applying for a Level 2 geriatric ED and there are questions about your application, then you may be asked to arrange a one-day site visit. Level 3 accreditation does not require a site visit.
Following the site visits, if needed, your application must be approved by the GEDA Board of Governors. The entire process is anticipated to take approximately 16-18 weeks, depending on application level.
If you deleted your application and have changed your mind contact us via email . Applications that are older than five months will not be reinstated.
Current online application fees:
Level 1: $15,000 Level 2: $7,500 Level 3: $2,500Level 1 requires a site visit and a reviewer can request a site visit for Level 2. Applicants are responsible for arranging and reimbursing the site visitor for travel, lodging and expenses related to the visit. Accreditation will be granted for 3 years.
In addition to the application itself, there are a number of documents that will be required to complete your application. You can visit the Getting Started page for a list of sample documents to get you started.
Please review the sample documents page and gather these required elements before starting your online application.
Use of Telehealth to meet Level 1 & 2 GEDA Requirements
Geriatric Emergency Medicine places a strong emphasis on interdisciplinary teamwork, and this is reflected in the GEDA requirements for accredited Geriatric EDs. In particular, the GEDA requirements for Level 1 & 2 GEDs include many of the following for each applying ED: 56 hours case management/ social work coverage per week in the ED, medication management/ pharmacy coverage, physical therapy, and occupational therapy. However, many EDs that seek (or may seek) GEDA Level 1 or 2 recognition are smaller and/ or rural EDs where it is unlikely that many of these services can be based in the ED due to the fewer number of patients needing their services at any one time. As such, it may make sense for these EDs to use telehealth to provide these interdisciplinary services. As an alternative platform for care delivery, Telehealth has gained traction in many clinical domains across multiple specialties including emergency medicine. Given that little is currently known about the efficacy of telehealth to provide these interdisciplinary services, this toolbox is provided to set guidelines for how EDs might consider the use of telehealth to meet these GEDA application requirements. GEDA recognizes and supports the use of telemedicine to address certain services that are not currently available.
The GEDA Upgrade Program is available to any Level 2 or Level 3 site that wishes to achieve a higher level of accreditation within their three-year award timeframe. The process to upgrade is seamless and the fee paid with your initial accreditation will count towards the upgrade cost (as long as the upgrade takes place within the initial accreditation term.)
Yes! Read about Geriatric Emergency Departments (PDF). Reproduced with permission from ACEP’s Emergency Department Design: A Practical Guide to Planning for the Future, 2nd Ed., by Jon Huddy, AIA
Level 1 and Level 2 applications will be required to provide their GED process flow. See examples:
Know and align care with each older adult’s specific health outcome goals and care preferences including, but not limited to, end-of-life care, and across settings of care.
If medication is necessary, use Age-Friendly medication that does not interfere with What Matters to the older adult, Mobility, or Mentation across settings of care.
Prevent, identify, treat, and manage dementia, depression, and delirium across settings of care.
Ensure that older adults move safely every day in order to maintain function and do What Matters.
An initiative of The John A. Hartford Foundation and the Institutue for Healthcare Improvement (IHI) in partnership with the American Hospital Association (AHA) and the Catholic Health Association of the United States (CHA).
