Concepts in Practice: Geriatric Emergency Departments
Concepts in Practice: Geriatric Emergency Departments
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DOI：
10.1016/j.annemergmed.2019.08.430
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发表时间：
2020-02-01
影响因子：
6.2
通讯作者：
Carpenter, Christopher R.
中科院分区：
文献类型：
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作者：
Southerland, Lauren T.;Lo, Alexander X.;Carpenter, Christopher R.
2018年，美国急诊医师学会（ACEP）根据2014年发布的多组织指南，开始将设施认证为“老年急诊科”（ED）。制定该指南是为了帮助每个艾德改善对老年人的护理。老年艾德指南的建议涵盖了从院外护理、艾德人员配备、协议、基础设施和过渡到门诊护理的护理连续体。因此，有兴趣使他们的急诊室更适合老年人的医院面临着以具有成本效益的方式并在其设施和工作人员的能力范围内采用，调整和实施广泛的指南建议的挑战。因为所有的创新都是本地的，必须在本地资源的限制下发挥作用，不同的医院系统根据其不同的机构能力和资源，制定了老年艾德指南的实施流程。本文介绍了4种老年艾德护理模式，为考虑发展老年ED的机构提供实际的例子和指导：老年ED特定单位，老年医学从业者模型，老年冠军，老年重点观察单位。每个模型的优点和局限性进行了比较，并提供了具体的机构和他们的业务指标的例子。
In 2018, the American College of Emergency Physicians (ACEP) began accrediting facilities as "geriatric emergency departments" (EDs) according to adherence to the multiorganizational guidelines published in 2014. The guidelines were developed to help every ED improve its care of older adults. The geriatric ED guideline recommendations span the care continuum from out-of-hospital care, ED staffing, protocols, infrastructure, and transitions to outpatient care. Hospitals interested in making their EDs more geriatric friendly thus face the challenge of adopting, adapting, and implementing extensive guideline recommendations in a cost-effective manner and within the capabilities of their facilities and staff. Because all innovation is at heart local and must function within the constraints of local resources, different hospital systems have developed implementation processes for the geriatric ED guidelines according to their differing institutional capabilities and resources. This article describes 4 geriatric ED models of care to provide practical examples and guidance for institutions considering developing geriatric EDs: a geriatric ED-specific unit, geriatrics practitioner models, geriatric champions, and geriatric-focused observation units. The advantages and limitations of each model are compared and examples of specific institutions and their operational metrics are provided.