Geriatric Emergency Department Screening Higher at Accredited VA Facilities

Geriatric emergency department (GED) screening rates were higher in Veterans Affairs (VA) facilities with GED accreditation after the VA’s efforts to improve emergency services for older veterans, according to findings published in Academic Emergency Medicine.

The VA Office of Emergency Management partnered with the Office of Geriatrics and Extended Care in 2018. Under the partnership, a core team worked with VA hospitals to promote age-friendly care models, standardize practice, and achieve GED accreditation, according to study authors.

Using the VA Corporate Data Warehouse and observational evaluations, researchers looked at the number of GED screenings from January 2018 to March 2022 among veterans aged 65 years or older. Data indicated fewer than half (50 out of 111) of VA emergency departments had secured or applied for GED accreditation by early 2022.

The study included 1.07 million veterans who were predominantly male (96.5%) and White (68%) and were an average 73.4 years of age (SD=7.2). There were 4.07 million VA emergency department visits during the study period, with 89.9% of veterans visiting a non-GED facility.

By the early months of 2022, 8.3% of veterans’ emergency department visits included at least 1 GED screen. Of these, 15% of veterans were screened at Level 1, 2, or 3 GEDs, while only 2.2% of veterans were screened at non-GED facilities. Level 1 GEDs were associated with 76-fold higher odds of screening as compared to Level 3 GEDs (OR=75.8 [95% CI 72.8, 79.0]).

GED screens were often used to identify veterans at risk for poor outcomes, delirium, and falls, researchers said.

Through the partnership, “the VA has created, standardized, and disseminated a GED Model of Care, despite the pandemic,” investigators concluded. “GED accreditation was associated with GED screen implementation, with Level 1 having the highest screening prevalence.”

Reference:
Hwang U, Runels T, Han L, et al. Dissemination and implementation of age-friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals. Acad Emerg Med. Published online January 18, 2023. doi:10.1111/acem.14665