Triaging seniors in health crisis in the emergency department: a three-year summary.

The "geriatric triage" approach for management of the most complex frail older adult population by geriatric nurses in the emergency department setting was a benefit to the patient/family and the health care system. The patients, through assessment and individualized plans of care, received the right care in the right setting. Seniors were assessed and their care planned by health care professionals who had geriatric knowledge, understood the complexity of their problems, and acted as their advocate. Geriatric triaging resulted in benefits across the health care system. Resources were used effectively. Patients received care in the most appropriate and cost-efficient setting. This new and creative approach served as a catalyst for improvement in services and care for the senior population. Health care workers in the hospitals as well as the community increased their knowledge of geriatrics through consultation with this service. The community and hospitals had a formal linkage, which provided an opportunity for collaboration and continuity of care. The hospital system experienced decreased competition for scarce acute care beds due to diverted admissions. The emergency department had consultants to assist with the decision-making for this high-risk population and decreased the number of patients held in emergency department awaiting an inpatient bed. The community system received patients with a comprehensive plan of care that provided creative and innovative care management strategies. Home care adapted its service to respond with immediate services to assist with health crises in addition to what had been traditionally available. The finding of this study supports a new approach to care of the elderly and chronically ill population who present to the emergency department in health crisis. Creative strategies are required to meet the needs of the aging population in these times of fiscal restraint. The nursing geriatric triage service is one strategy that holds merit.