Citation

Jones S, Wallis P. Clin. Med. (Lond.) 2013; 13(6): 561-564.

Affiliation

Birmingham Heartlands Hospital, Heart of England Foundation Trust, UK.

Copyright

(Copyright © 2013, Royal College of Physicians of London)

DOI

10.7861/clinmedicine.13-6-561

PMID

24298101

Abstract

The decision to admit a frail older patient is rarely made by a geriatrician and often falls to staff in the emergency department (ED), who may not have the training to balance the risks, benefits and alternatives. We based a consultant geriatrician in the ED with the primary aim of facilitating admission prevention for older patients and this was achieved for 64% (543/848) of patients. A secondary aim was to facilitate direct admission to elderly care wards when admission was necessary, and this was achieved for 57% of admitted patients (174/305). The geriatrician was able to facilitate discharge from the ED for over half of potential 30-day readmissions seen. The overall 7-day ED re-attendance rate was 10.1%, but only 3.4% of patients were admitted with the same problem, indicating true admission prevention rather than admission delay. In conclusion, the placement of a consultant geriatrician in the ED is effective in facilitating admission prevention for older patients.

Language: en