Emergency Department-to-Community Transitions of Care: Best Practices for the Older Adult Population
June 14, 2023
IMPACT Career Development Awardee, Cameron Gettel, MD, co-authored an article describing emergency department (ED)-to-community care transitions for older adults. The article emphasizes that older adults visiting the ED often have chronic illnesses and impairments, making effective care transitions critical to good health outcomes. Inadequate communication and poor patient comprehension of medical conditions during ED-to-community care transitions can lead to adverse health outcomes. The authors suggest that effective ER-to-community care transitions should focus on the period immediately after ED visits with coordinated care strategies, as well as the development of best practice guidelines.
Abstract
This article describes emergency department (ED)-to-community care transitions for older adults and associated challenges, measurement, proven efficacious and effective interventions, and policy considerations. Older adults experiencing social isolation and impairments in functional status or cognition represent unique populations that are particularly at risk during ED-to-community transitions of care and may benefit from targeted intervention implementation. Future efforts should target optimizing screening techniques to identify those at risk, developing and validating patient-centered outcome measures, and using policy and reimbursement levers to include transitional care management services for older adults within the ED setting.
Key Points
- Opportunities for improved communication with older adults and their care partners during ED-to-community care transitions may help overcome common adverse events after ED discharge.
- Older adults experiencing social isolation and those with impaired mobility or cognition represent unique populations that are particularly at risk during ED-to-community transitions of care.
- Care transition interventions to date have had variable efficacy and effectiveness in reducing ED revisit rates, yet promising solutions that target at-risk populations exist.
- Investment in transitional care management services in EDs could position ED clinicians, patients, and their care partners to reduce adverse events during this care transition.