Date of Graduation

Spring 2016

Document Type

Honors Research Project

Degree Name

Bachelor of Science

Major

Biology

Research Sponsor

Scott T. Wilber

First Reader

Mark M. Fridline

Second Reader

Jennifer Frey

Abstract

Objectives: To compare the outcomes of patients seen during a pilot Senior Emergency Department (ED) program to a historical cohort of geriatric patients receiving usual ED care.

Methods: We performed a retrospective cohort analysis of quality assurance data obtained to evaluate the implementation of a pilot Senior ED program at a 78,000 visit hospital ED. The historical cohort covered 1/23/2012 to 12/31/2012. The pilot Senior ED program was implemented from 1/1/2013 to 12/31/2013. Patients 65 years and older arriving between 8:30 am and 8:30 pm were triaged to a 15 bed Senior ED. Interventions included assessment by a nurse transitional care coordinator, care protocols, education, pharmacy review and call backs on discharged patients. Data are presented as means, proportions, differences, and analyzed for statistical significance using the t-test where p<0.05 is considered significant.

Results: There were 12,503 eligible visits in 2012 and 13,627 eligible visits in 2013. The mean age was 78 years in both cohorts; 58% were female in 2012 and 53% in 2013. During the pilot Senior ED program length of stay was increased (2012: 287 minutes vs. 2013: 298 minutes), admissions were significantly decreased (54% vs. 49%, p=0.000), and observation patients increased (2.4% vs. 4.9%, p=0.000). During the pilot Senior ED program, discharges to home increased by 2.7% (p=0.000).

Conclusions: The pilot Senior ED program reduced inpatient admissions, increased observations, and increased discharges to home significantly showing the program’s effectiveness in managing acutely ill senior patients.

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