Table 1:
Geriatric specific protocols, policies, guidelines, or initiatives enacted at US GEDs.
| Protocol/ Policy, n (%) | Level 1 (n = 14) | Level 2 (n = 21) | Level 3 (n=190) |
|---|---|---|---|
| Program to minimization use of urinary catheters | 14 (100) | 20 (95) | 53 (28) |
| Process for identification of elder abuse | 14 (100) | 14 (67) | 25 (13) |
| Program to minimize use of physical restraints | 14 (100) | 14 (67) | 11 (6) |
| Access to palliative care consultation | 14 (100) | 11 (52) | 10 (5) |
| Geriatric pain control guidelines | 14 (100) | 11 (52) | 4 (2) |
| Program on geriatric fall assessment | 13 (93) | 18 (86) | 59 (31) |
| Process for PCP notification | 13 (93) | 14 (67) | 2 (1) |
| Access to transportation services for return to home | 13 (93) | 12 (57) | 0 (0) |
| Program to minimize use of potentially inappropriate medications | 13 (93) | 11 (52) | 9 (5) |
| Delirium screening process | 13 (93) | 9 (43) | 27 (14) |
| Process for care transitions to residential care facilities | 13 (93) | 8 (38) | 0 (0) |
| Guideline to define access to GED from ED triage* | 13 (93) | 6 (29) | N/A* |
| Process for medication reconciliation with a pharmacist | 12 (86) | 9 (43) | 16 (8) |
| Standardized assessment of function and functional decline | 12 (86) | 8 (38) | 27 (14) |
| Dementia screening process | 12 (86) | 5 (24) | 5 (3) |
| Guidelines to minimize NPO designation | 11 (79) | 7 (33) | 2 (1) |
| Program for access to short and long-term rehabilitation | 11 (79) | 5 (24) | 1 (0.5) |
| Program for volunteer engagement | 10 (71) | 5 (24) | 0 (0) |
| Guideline to promote mobility | 11 (79) | 3 (14) | 1 (0.5) |
| Process for post-discharge follow up | 11 (79) | 2 (10) | 3 (2) |
| Access to geriatric psychiatry consultation | 10 (71) | 5 (24) | 5 (3) |
| Program for home assessment of function and safety | 9 (64) | 6 (29) | 0 (0) |
| Access to geriatric specific outpatient clinics for follow up | 9 (64) | 5 (24) | 3 (2) |
| Order sets for ≥3 common geriatric presentations | 8 (57) | 9 (43) | 4 (2) |
| Program for community paramedicine follow up | 3 (21) | 2 (10) | 0 (0) |
| Outreach program to residential care homes | 1 (7) | 4 (19) | 0 (0) |
N=225 - one Level 1 GED was not included due to restrictions in the data use agreement. Level 1 GEDs are required to have at least 20 items and Level 2 GEDs are required to have at least 10 items from the GEDA model of care. Level 3 GEDs are required to have at least one quality initiative, which were reclassified into the GEDA model of care structure. Sites may have exceeded the number of required items. Five GEDs applied for and were accredited at a higher GEDA level; data from original and updated applications were both included under the respective accreditation level.
Not applicable to Level 3 GEDs. GED=Geriatric Emergency Department. ED=Emergency Department. PCP=Primary Care Physician. NPO= “Nil per os”/nothing by mouth.