Accreditation Levels - Silver
Staffing
- 1 MD or DO with evidence of 6 hours of focused education for geriatric EM
- 1 RN with evidence of focused education for geriatric EM
- Physician champion/Medical director
- Nurse case manager/transitional care nurse present > 56 hrs/week
- Interdisciplinary geriatric assessment team includes at least 2 roles
- At least executive/administrative sponsor supervising the geriatric ED program
Equipment and Supplies
- Access to mobility aids (canes, four-point walkers)
- Access to at least 3 supplies, excluding mobility aids
View PDF: Equipment & Supplies
Education
- Staff physician education related to 8 domains of GEM
View PDF: List of 8 Domains - Nursing education in geriatric emergency care (i.e., GENE, NICHE)
Quality Improvement
- Adherence to 10 components chosen in the Policies, Guidelines and Procedures section based on random chart audit
Care Processes, Policies, Guidelines and Procedures
- Required 7 geriatric care processes plus the three baseline required standard of care processes (urinary catheter minimization, NPO status minimization, and physical restraint minimization) from the GED model of care for a total of 10 care processes.
View PDF: ED Model of Care
Outcomes Measures
- Track at least 3 process and outcome metrics for eligible patients
View PDF: Metrics for Outcome Measures
Physical Environment
- Easy access to food/drink 24/7
- 2 chairs per patient bed
- Large analog clock
References
- Kahn JH, Magauran BG, Olshaker JS, Shankar KN. Current Trends in Geriatric Emergency Medicine. Emerg Med Clin North Am. Aug 2016;34(3):435452.
- Shaha M, Gmür S, Schoenenberger AW, Gerber FS, Exadaktylos AK. Trends and characteristics of attendance at the emergency department of a Swiss university hospital: 20022012. Swiss Med Wkly. May 21 2015;145:w14141.
- Carpenter CR, PlattsMills TF. Evolving prehospital, emergency department, and “inpatient” management models for geriatric emergencies. Clin Geriatr Med. Feb 2013;29(1):3147.
- Keehan SP, Cuckler GA, Sisko AM, et al. National health expenditure projections, 201424: spending growth faster than recent trends. Health Aff. Aug 2015;34(8): 14071417.
- Keehan SP, Poisal JA, Cuckler GA, et al. National Health Expenditure Projections, 201525: Economy, Prices, And Aging Expected To Shape Spending And Enrollment. Health Aff. Aug 2016;35(8):15221531.
- Hwang U, Shah MN, Han JH, Carpenter CR, Siu AL, Adams JG. Transforming emergency care for older adults. Health Aff. Dec 2013;32(12):21162121.
- Hogan TM, Losman ED, Carpenter CR, et al. Development of geriatric competencies for emergency medicine residents using an expert consensus process. Acad Emerg Med Mar 2010;17(3):316324.
- Carpenter CR, Heard K, Wilber ST, et al. Research priorities for high-quality geriatric emergency care: medication management, screening, and prevention and functional assessment. Acad Emerg Med. Jun 2011;18(6):644654.
- Carpenter CR, Shah MN, Hustey FM, Heard K, Miller DK. High yield research opportunities in geriatric emergency medicine research: prehospital care, delirium, adverse drug events, and falls. J Gerontol Med Sci. Jul 2011;66(7):775783.
- Rosenberg M, Carpenter CR, Bromley M, et al. Geriatric Emergency Department Guidelines. Ann Emerg Med. May 2014;63(5):e7e25.
- Carpenter CR, Lo AX. Falling Behind? Understanding Implementation Science in Future Emergency Department Management Strategies for Geriatric Fall Prevention. Acad Emerg Med. Apr 2015 22(4):478480.
- Carpenter CR, Griffey RT, Stark S, Coopersmith CM, Gage BF. Physician and Nurse Acceptance of Geriatric Technicians to Screen for Geriatric Syndromes in the Emergency Department. West J Emerg Med. Dec 2011;12(4):489495.
- Han JH, Zimmerman EE, Cutler N, et al. Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes. Acad Emerg Med. Mar 2009;16(3):193200.
- Tirrell G, Srion J, Lipsitz LA, Camargo CA, Kabrhel C, Liu SW. Evaluation of older adult patients with falls in the emergency department: discordance with national guidelines. Acad Emerg Med. Apr 2015 22(4):461467.
- Hogan TM, Olade TO, Carpenter CR. A profile of acute care in an aging America: snowball sample identification and characterization of United States geriatric emergency departments in 2013. Acad Emerg Med. Mar 2014 21(3):337346.