Emergency room referrals to a geriatric outreach team: the analysis of referral reasons.

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Kliewer, Sandra Sharon
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The purpose of this study was to explore the referrals that were generated from one hospital emergency room to a community outreach team. This study used a specific geriatric program assessment team in Winnipeg, Manitoba, Canada as the community outreach team. Malcolm Payne’s description of Task Centered Casework and Crisis Intervention and Irene Pollin’s Medical Crisis Counseling served as the theoretical structure and design to gain an understanding of the reasons geriatric patients were referred to the GPAT on discharge. This study aimed to answer three research questions: 1) What is the emergency room medical team’s main reason for referral to a geriatric outreach team? 2) Are the referrals received from the emergency room medical team clearly identifying psychosocial issues as areas for examination by an outreach team? 3) Are psychosocial issues identified only after an outreach team clinician completed a comprehensive assessment? This study revealed that out of the 209 referrals to geriatric program assessment team, the highest number of times referred was for functional decline. It revealed that the emergency room medical team saw functional decline as a valid reason to have the geriatric program assessment team assess the individual in their home settings to ensure that any functional issue be addressed and possible adaptations made in a timely manner to avoid the reverberation that one ailment can set off. The second most common reason for referring to the geriatric program assessment team was for social issues. Forty percent of the referrals identified that there were concerns in relation to social issues which clearly identifies that the emergency room medical team identified psychosocial issues as an area for further examination. And finally, the findings show psychosocial issues were not identified only after an outreach team clinician completed a comprehensive assessment, but that both appear cognizant of the interplay between medical issues and social issues.
geriatrics, geriatric assessment, older adults, outreach team, emergency room, emergency department, psychosocial, acute care, elderly, geriatric program assessment team