A survey of emergency department staff about challenges and recommendations for emergency department care of extended care facility patients.

OBJECTIVES

Extended care facility (ECF) patients who transfer to emergency departments (EDs) can pose problems when complicated health problems require extra resources. Higher numbers of older patients are projected to use EDs, so we aimed to identify problems now to implement solutions before they worsen in the future.

DESIGN

This was a prospective survey research study.

SETTING

ED in a safety net teaching hospital in the Midwest.

PARTICIPANTS

ED personnel.

MEASUREMENTS

Confidential, anonymous survey collected views and opinions of ED personnel about problematic issues related to emergency care of ECF residents. The survey targeted communication problems, patient satisfaction concerns, difficult characteristics of patient population, need for education, need for research--and solicited open-ended remarks.

RESULTS

ED staff reported concern about flawed communication and poor documentation from the ECF. Based on job title, divergent viewpoints were reported about pharmacological challenges and comfort levels in managing older patients in the ED. Top training priorities were special needs of older adults, detecting abuse in older adults, and specific medical and psychosocial issues associated with older adults. Increased communication among all levels of geriatric care is recommended, especially from extended care facility staff before patient arrival at the ED.

CONCLUSION

Because population projections predict an increasing trend of older adults, health care providers must think ahead and prepare for future medical needs. This survey was an inexpensive and effective way to identify next steps. We plan to use the survey results to initiate collaboration with ED staff, EMS providers, and ECF staff to identify specific actions to improve acute care for elderly patients--for the present and the future.