Background Many Australian hospitals have Geriatrician in Emergency Department team/s, ours does not. Due to a redistribution of staff, we had opportunity to pilot a Geriatrician in ED Initiative (GEDI) three days a week for six months in 2024.
Aims We aimed to describe the cohort of patients seen by GEDI in the Emergency Department. An additional aim was to assess the differences in identification of delirium by GEDI versus standard care of the Emergency department.
Methods A prospective cohort study of individuals reviewed by the GEDI between March and September 2024 was undertaken. Eligibility for GEDI review were patients >65yrs. Patients were excluded if they were already referred to other teams for direct subacute admission. Data collected included patient specific demographic data, routinely collected ED data (including ED cognitive assessment) and GEDI routinely collected data (GEDI cognitive assessment, GEDI Clinical frailty scale).
Results There were 83 patients reviewed by GEDI in 70 allocated sessions. Average age of patients was 83 years with the majority from private residences (60%). 70% had a Clinical Frailty Scale of 5-8 and 59% had pre-existing cognitive impairment or known dementia. Of those without pre-existing cognitive impairment, ED correctly identified delirium in only 13%, compared to GEDI identifying delirium in 30% of patients.
Conclusions Having a Geriatrician in ED provides opportunity to improve the identification of older patients at risk of delirium and other geriatric syndromes. More collaboration within our hospital is required to provide opportunities for patients to have earlier access to Geriatricians.