Pathfinder

Traditionally, in the Republic of Ireland (ROI), all patients are brought to the Emergency Department (ED) following an Emergency Medical Services (EMS) call, unless they decline to travel. The EMS call is activated by dialling 999/112. The increase in older people with complex multi-morbidity has been identified as a key driver to ED crowding. Older people are particularly vulnerable to adverse events associated with ED presentation,

ED physician-based nursing home assistance

Claus-Henrik Rasmussen, Nina Andersen, Søren Mikkelsen, Mikkel Brabrand, Annmarie Lassen

As an alternative to ambulance transport to the Emergency Department (ED) and in-hospital evaluation and treatment, we thought it would be possible to conduct acute evaluation and treatment on site in the nursing home.  In our service model this is completed by a trained emergency physician from the local ED in collaboration with a high qualified acute team nurses from the local municipality and can provide an alternative to hospitalization.

Developing a Provincial Emergency Department Delirium Pathway

Britanny Ellis

Delirium is a commonly missed diagnosis in emergency departments throughout the world, and this is associated with poor patient outcomes, and increased health care costs. Studies around the world have consistently demonstrated that a large number (roughly 70-80%) of delirium cases are missed in the ED, and that over 90% of these missed cases are subsequently missed on inpatient units (Han et al,

Value-based care of older people

Maaret Castrén, Lauri Mäki

Long-term residential care facility (LTRCF) residents are often transferred to emergency departments due to relatively minor health problems that could be treated in the facility. These transfers are burdensome for the residents and often lead to adverse effects. Older adults living in nursing homes or receiving long-term home care are in higher risk of losing their daily functional capacities or dying after hospital care compared to independently living older adults.

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