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Responding to the ageing profile of emergency department patients

conference contribution
posted on 2009-01-01, 00:00 authored by K Hill, Julie ConsidineJulie Considine, R Smith, J Gannon, M Graco, C Behm, T Weiland, P Wellington, S McCarthy, S Corrie
Background
Older people with acute superimposed on chronic health problems are becoming a core aspect of emergency department (ED) caseload. This project explored the ED experience from the perspective of older patients and their carers.

Method
A convenience sample of thirty participants was recruited across three participating EDs: tw o metropolitan and one regional. The project utilised two approaches to data collection: 1) an observation approach where a project officer observed participants from the time of ED presentation until discharge, or for up to six hours; and 2) a subsequent interview was conducted with the participant and their carer within a week of the ED presentation. Data from both sources were integrated, and independently thematically analysed by two members of the team.

Results
Thirty participants aged over 65 were recruited. Their average age was 77.1 (sd=6.7) years, 59% w ere female, and 74% were triage category 1- 3 (indicating moderate/high acuity). Participants spent on average 7 hours 47 minutes in the ED, with 50% discharged home, 43% admitted to general wards or MAPU, and 7% discharged to residential care/hospice. Key themes in the factors influencing the patient experience and examples of quality care were identified, along with opportunities to improve the capacity for EDs to be “older person friendly”, and “person-centred.” Challenges include improving the effectiveness of communication between staff and patients/carers (including issues around people from culturally and linguistically diverse backgrounds), availability of allied health professionals to assist with discharge planning, and a tendency for older people not to seek ED care until the health problem was severe. Patient exemplars highlight key themes.

Discussion and implications

Results of the project highlight positive aspects of emergency department care for older people and inform targets for improvement strategies. These can be used to drive ongoing improvements in care for older people presenting to EDs.

History

Event

New Zealand Association of Gerontology & Age Concern New Zealand Conference (2009 : Wellington, New Zealand)

Publisher

[New Zealand Association of Gerontology]

Location

Wellington, New Zealand

Place of publication

[Wellington, New Zealand]

Start date

2009-10-07

End date

2009-10-09

Language

eng

Notes

In press. check after Jan 2010.

Publication classification

E3 Extract of paper

Copyright notice

2009, NZAG

Title of proceedings

Living in an ageing society : shaping tomorrow today : Proceedings of the 2009 New Zealand Association of Gerontology & Age Concern New Zealand Conference

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