Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use

Journal of the American Geriatrics Society
Ula HwangGEDI WISE Investigators

Abstract

To examine the effect of an emergency department (ED)-based transitional care nurse (TCN) on hospital use. Prospective observational cohort. Three U.S. (NY, IL, NJ) EDs from January 1, 2013, to June 30, 2015. Individuals aged 65 and older in the ED (N = 57,287). The intervention was first TCN contact. Controls never saw a TCN during the study period. We examined sociodemographic and clinical characteristics associated with TCN use and outcomes. The primary outcome was inpatient admission during the index ED visit (admission on Day 0). Secondary outcomes included cumulative 30-day admission (any admission on Days 0-30) and 72-hour ED revisits. A TCN saw 5,930 (10%) individuals, 42% of whom were admitted. After accounting for observed selection bias using entropy balance, results showed that when compared to controls, TCN contact was associated with lower risk of admission (site 1: -9.9% risk of inpatient admission, 95% confidence interval (CI) = -12.3% to -7.5%; site 2: -16.5%, 95% CI = -18.7% to -14.2%; site 3: -4.7%, 95% CI = -7.5% to -2.0%). Participants with TCN contact had greater risk of a 72-hour ED revisit at two sites (site 1: 1.5%, 95% CI = 0.7-2.3%; site 2: 1.4%, 95% CI = 0.7-2.1%). Risk of any admission within 30 day...Continue Reading

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Citations

Aug 11, 2018·Journal of the American Geriatrics Society·Manish N ShahEric A Coleman
Mar 16, 2019·Journal of the American Geriatrics Society·Jaime M HughesJohn W Williams
Nov 5, 2019·Health Affairs·Michele Cohen Marill
Apr 27, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Alexander X Lo, Christopher R Carpenter
Aug 6, 2020·European Geriatric Medicine·Duygu SezginUNKNOWN all EU ADVANTAGE Joint Action Work Package 7 partners
Oct 31, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Scott M DresdenLynne Richardson
Mar 19, 2019·Emergency Medicine Australasia : EMA·Lauren T SoutherlandGlenn Arendts
Dec 12, 2019·Revista brasileira de enfermagem·Leidyani Karina RissardoLígia Carreira
Aug 11, 2020·Systematic Reviews·Christiane Pereira Martins CasteliMarie-Pierre Gagnon
Dec 5, 2018·BMC Geriatrics·Marianne WallisJulia Crilly
Apr 28, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Lauren T SoutherlandGregory Archual
Dec 2, 2020·Medicina·Sonia Ortega RomeroGuillermo Arturo Cañadas-De la Fuente
Mar 7, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Alexander X LoScott M Dresden
Apr 23, 2021·Emergency Medicine Journal : EMJ·Vera M HogervorstSimon Paul Conroy
May 20, 2021·The Journal of Emergency Medicine·Aladdin H ShadyabVaishal M Tolia
Jun 27, 2021·The Journal of Emergency Medicine·Aladdin H ShadyabEdward M Castillo
Jul 22, 2021·Revista brasileira de enfermagem·Cláudia Fernanda Trindade SilvaMonaliza Lemos de Souza
Nov 2, 2020·The American Journal of Emergency Medicine·Jill M HudedTodd I Smith
Jul 27, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Gwen C JacobsohnManish N Shah
Nov 26, 2021·Journal of the American Geriatrics Society·Jill M HudedRobert A Bonomo

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