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VA Geriatric Emergency Department Program (Previously GERI-VET)
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National VA Geriatric Emergency Department Mission is Enhancing
geriatric-focused care in VA emergency departments throughout the nation via education, standardization, environmental enhancement, and promotion of a comprehensive care model. This initiative grew out of a pilot in at the Cleveland VAMC: Geriatric Emergency Room Interventions for Veterans (GERI-VET), an evidence-based multidisciplinary program performing geriatric screens and care coordination for at-risk older Veterans treated in the ED, was implemented based on established best practices for Geriatric ED care. ED staff receive multimodal geriatric emergency medicine training and champion the care of the most frail, older Veterans during their ED visit. Geri-Vet served as a platform for Geriatric ED Accreditation through the American College of Emergency Physicians.
Origin:
December 2016, Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio)
Adoptions:
67 successful, 22 in-progress, 1 unsuccessful
Awards and Recognition:
Diffusion of Excellence Promising Practice, American College of Emergency Medicine Accredited Health System Geriatric Emergency Department
Partners:
Diffusion of Excellence, Emergency Medicine, Geriatrics and Extended Care, Office of Rural Health, VHA Innovators Network
Recent Updates
Overview
Problem
Solution
-Detecting unrecognized geriatric syndromes for older Veterans in the ED (age 65+)
-Providing evidence-based emergency care for age-specific need ... With the aim of providing comprehensive, geriatric-focused care, Louis Stokes Cleveland VAMC initiated their geriatric emergency department (GED) program in December 2016. The objectives of the program include:
-Detecting unrecognized geriatric syndromes for older Veterans in the ED (age 65+)
-Providing evidence-based emergency care for age-specific needs
-Ensuring comprehensive care coordination and timely referrals for VA and community resources
-Providing training for ED staff to champion this care See more
- Diffusion of Excellence GED Practice Overview Geriatric ED Summary
- Innovation New Emergency Room Initiative VA North Texas
Files
Links
Results
Images
Estimated Cost Avoidance Savings based on program analysis of Louis Stokes Cleveland VAMC Geriatric Emergency Department Program (2019 data)
Links
- Geriatric ED enterprise wide spread Dissemination and implementation of age-friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
Veteran being assessed for physical, psychological, and social factors that impact the older Veterans’ overall health.
Geriatric ED group engages others to works collaboratively to ensure proper measures are in place to treat all Veteran and caregiver needs upon discharge from the ED
Geriatric ED training through in person boot camps (online training also available)
Videos
Dr. Todd Smith discusses the Geriatric ED program for the 2018 VA Innovation Experience
Implementation
Timeline
-
Month 1
Identify Geriatric ED champions -
Months 1-3
Multimodal geriatric ED education for ED staff -
Months 1-3
Build Geriatric ED documentation in CPRS (National Template, GERIATRIC ED NOTE TEMPLATE, must be used per Emergency Medicine Memo if performing the following screens: Identifying Seniors at Risk, Delirium Triage Screen, Brief Confusion Assessment Method, Mini-Cog, STopping Elderly Accidents Death and Injury (STEADI), Katz Activities of Daily Living, Zarit Caregiver Burden 4-Question) -
Month 1-3
Socialize your program with related VA departments and services (eg Geriatrics, Primary Care, Physical and Occupational Therapy, Prosthetics, Pharmacy, Mental Health, Homecare, Telehealth, Social Work) -
Month 3-6
Initiate geriatric screens and care coordination -
Month 6-9
Apply for Geriatric ED Accreditation through the American College of Emergency Physicians -
Month 6-Sustainment
Plan-Do-Study-Act continuous quality improvement
Departments
- Social work
- Emergency care
- Pharmacy
- Geriatrics
- Caregiver support
- Education and training
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
Files
Links
- Internal VA Sharepoint National VA Geriatric ED
- Journal of Geriatric Emergency Medicine Intermediate Care Technicians-A Novel Workforce for Veterans Affairs Geriatric Emergency Departments
Optional Resources
Links
- Press release on National Collaboration to Promote Geriatric Emergency Medicine Care throughout the VA VA Enhances Geriatric Emergency Care for Older Veterans
- Special Issue on Veteran Emergency Care April 2023 Academic Emergency Medicine Volume 30, Issue 4
- VA News article on the spread of geriatric emergency medicine within the VA VA emergency departments ready for growing population of older Veterans
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Detection of acute geriatric syndromes warranting follow-up. | Provide education on geriatric care plans and VA resources to multidisciplinary ED staff. |
About
Origin story
Original team
Dr. Robert Bonomo/Director of Cleveland GRECC
Dr. Chad Kessler/National Director of Emergency Medicine
Dr. Tom Edes/Director of Comprehensive Geriatrics & Palliative Care Clinical Operations
Dr. Jill Huded
Founder
Dr. Colleen McQuown
Director, Geriatric Emergency Medicine, Louis Stokes Cleveland VA Medical Center
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