INCORPORATION OF MULTIDISCIPLINARY GERIATRIC CARE INTO AN EMERGENCY DEPARTMENT OBSERVATION UNIT

Multidisciplinary geriatric assessment is difficult in the Emergency Department (ED) due to time limitations, patient volume, and specialized staffing needs. One solution is ED Observation Units which provide extended patient evaluations for up to 24 hours. Our ED implemented multidisciplinary geriatrician assessment including geriatric consultation, physical therapy assessment, and case management care coordination, available to any observation unit patients. We conducted a retrospective chart review of randomly selected adult observation unit patients ≥65 years old (n=111). Few were observed purely for geriatric assessment (7.2%, n=8), but 25% (n=28) accessed at least one of the multidisciplinary assessments. The admission rate was 24% with average length of stay 15.5 hours. The admission rate for patients placed specifically for geriatric assessment was 62% (n=5/8). Multidisciplinary geriatric assessment is frequently utilized and feasible in an ED observation unit, but a higher admission rate should be anticipated in patients observed for this purpose only.