Senior-Friendly Emergency Departments Combine Care-Model Innovation With Local Adaptation

	Participants	Strengths	Limitations
GED Boot Camp	Physicians & nurses* Physiotherapy Pharmacy Case managers Community partners† Hospital administrators Insurers Patients & families	Employs implementation science and QI to promote practice change You Might Also Like Senior EDs: More Than Better Lighting ACEP Accredits Geriatric Emergency Care for Emergency Departments New Guidelines Enhance Care Standards for Elderly Patients in the ED Focused pre-planning and sustained follow-up with local opinion leaders Engagement of multiple disciplines with a health care system’s hierarchy QI work product and data stream to measure effectiveness	Time- and labor-intensive for Boot Camp sites & organizers Expensive Engagement of limited number of health care systems thus far Await proof-of-concept
Senior-Friendly ED	Physicians & nurses‡ Hospital administrators	Engagement of broad array of hospitals across provinces Linkage to large EM meetings§ QI work product	Involvement of only a few individuals from any one hospital Await proof-of-concept
Integrated Care Symposium	Physicians & nurses* Insurers Community partners† Hospital administrators Policy makers	Linkage of older persons workshop to multi-stakeholder integrated care symposium	Await proof-of-concept No individualized pre-planning or QI project

^* Emergency department, hospitalists, primary care, geriatricians
^† Home health services, Meals on Wheels, transportation services, Alzheimer’s Association
^‡ Emergency department and geriatricians
^§ ED Administration Conference, Western ED Operations Conference

As summarized in the above table, each approach has advantages and disadvantages, but each awaits definitive proof-of-concept.⁷

The expansion of geriatric care in EDs will continue, and we as EM providers have the opportunity to either define best practices or have best practices defined for it by others.⁸ Delivering high-quality, patient-centric emergency care for an aging population will remain a challenge and will require a team-based approach. A one-size-fits-all solution to bridge disciplines and create comprehensive ED geriatric care is unlikely, so the best strategy is to link innovation and providers in a multipronged approach similar to that seen in the growth of cardiac, stroke, trauma, and pediatric care.

Dr. Melady is employed at Mount Sinai Hospital in Toronto. Follow him on Twitter at @geri_EM.