Older ED patients have higher admission rates than any other age group and hospitalizations can result in complications, delirium, declining function and loss of independence. These higher admission rates can also be a significant cost to the system.
The Geriatric Emergency Department model focuses on admitting only the older patients with the highest acuity. It provides a standardized approach to care, ensures optimal transitions and focuses on minimizing the risk of complications for those who require an inpatient bed, according to an article published on the ACEP Geriatric Emergency Department Accreditation website.
The program utilizes EHR integration with all the care initiatives, provides early delirium detection, improves transition of care and geriatric emergency care education. The model has each emergency department dedicated a geriatric ED unit, a geriatric practitioner and physician, a geriatrics champion model and a geriatric-focused observation unit. It is being used in all 13 of Cleveland Clinic’s EDs and the results have been good for geriatric patients, according to the report.
- It reduced potentially avoidable admissions by 73%. Of 449 patients evaluated in 2022 to 2023, those who saw the geriatrics ED team had an admission rate of 17%, compared to 55% for those not seen by the team.
- It reduced low-value admission and decreased Medicare expenditures, saving approximately $35,000 per admission. The avoided admissions could have saved more than $2.8 million.
- It reduced length of stay for admitted patients.
- The combined net revenue for the program in the last four years was approximately $15.25 million.
