Selection of Geriatric Rehabilitation Clients by Geriatric Clinicians in Emergency Departments
Graceffo, Eleanor Marlene
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The purpose of this study was to compare the discharge outcomes of two client groups who were admitted to geriatric rehabilitation units (GRUs). The Emergency Department or ED Group were clients seen by WRHA Geriatric Program Assessment Team (GPAT) geriatric clinicians in EDs and admitted directly to geriatric rehabilitation units and the Acute Group were clients admitted from inpatient acute care units to geriatric rehabilitation units. The study design was a retrospective study using administrative data to examine two groups for the following discharge outcomes: discharged home, discharged to personal care home, and poor outcomes of either medical instability or mortality. The study results found that 70% of clients assessed by GPAT clinicians and admitted from the ED directly to a GRU were discharged home. Similarly, 68% of the clients admitted from acute inpatient units to a GRU were discharged home. The discharge home outcomes indicate that geriatric clinicians in consultation with team Geriatricians were able to select geriatric rehabilitation clients in a busy ED despite the need for an abbreviated evaluation period requiring rapid decision-making. Results of the study indicate that clinicians in this unique GPAT program utilizing collaboration between the ED team and clear GRU admission criteria selected ED clients with potential to benefit from the rehabilitation process and return to their homes in the community. Furthermore, 6% of the ED Group cases had poor outcomes of medical instability or mortality and 10% of the Acute Group had poor outcomes following GRU admission (see Table2).