Study objective

The objectives of this study were to describe the reach and adoption of Geriatric Emergency Department Accreditation (GEDA) program and care processes instituted at accredited geriatric emergency departments (EDs).

Methods

We analyzed a cross-section of a cohort of US EDs that received GEDA from May 2018 to March 2021. We obtained data from the American College of Emergency Physicians and publicly available sources. Data included GEDA level, geographic location, urban/rural designation, and care processes instituted. Frequencies and proportions and median and interquartile ranges were used to summarize categorical and continuous data, respectively.

Results

Over the study period, 225 US geriatric ED accreditations were issued and included in our analysis—14 Level 1, 21 Level 2, and 190 Level 3 geriatric EDs; 5 geriatric EDs reapplied and received higher-level accreditation after initial accreditation at a lower level. Only 9 geriatric EDs were in rural regions. There was significant heterogeneity in protocols enacted at geriatric EDs; minimizing urinary catheter use and fall prevention were the most common.

Conclusion

There has been rapid growth in geriatric EDs, driven by Level 3 accreditation. Most geriatric EDs are in urban areas, indicating the potential need for expansion beyond these areas. Future research evaluating the impact of GEDA on health care utilization and patient-oriented outcomes is needed.

中文翻译：

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美国老年急诊科认证计划的达成和采用

学习目的

本研究的目的是描述老年急诊科认证 (GEDA) 计划的覆盖范围和采用情况以及经认可的老年急诊科 (ED) 制定的护理流程。

方法

我们对 2018 年 5 月至 2021 年 3 月期间接受 GEDA 的一组美国急诊室进行了横截面分析。我们从美国急诊医师学会和公开来源获得了数据。数据包括 GEDA 级别、地理位置、城市/乡村名称以及制定的护理流程。频率和比例以及中位数和四分位数范围分别用于总结分类数据和连续数据。

结果

在研究期间，颁发了 225 个美国老年急诊科认证，并将其纳入我们的分析中——14 个 1 级、21 个 2 级和 190 个 3 级老年急诊科；5 名老年急诊科在最初获得较低级别的认证后，重新申请并获得了更高级别的认证。只有 9 名老年急诊室位于农村地区。老年急诊室制定的方案存在显着的异质性；减少导尿管的使用和预防跌倒是最常见的。

结论

在 3 级认证的推动下，老年急诊迅速增长。大多数老年急诊都位于城市地区，这表明潜在需要扩展到这些地区之外。未来需要开展研究来评估 GEDA 对医疗保健利用和以患者为导向的结果的影响。