PROJECT 

 

PROJECT TITLE:

Age-Friendly Healthcare in the Mid-West: The Geriatric Emergency Medicine Unit

 

TEAM:

• Dr Íde O’Shaughnessy, Clinical Specialist Occupational Therapist

• Dr Caitriona Mullarkey, Emergency Medicine Consultant, University Hospital Limerick

 

LOCATION:

Emergency Department, University Hospital Limerick

 

THE PROBLEM:

There is unequivocal consensus that the emergency department (ED) is a challenging environment to deliver holistic care to older adults living with frailty. Prolonged exposure to the ED environment predisposes older adults to a range of adverse outcomes e.g. deconditioning, delirium, malnutrition etc. From a systems perspective, there is an urgent need to re-evaluate configuration of services to meet the multifactorial needs of older adults.

 

THE SOLUTION:

The Geriatric Emergency Medicine (GEM) Unit opened in University Hospital Limerick (UHL) in 2023 and is staffed by an interdisciplinary team comprising Emergency Medicine, Nursing, and Health and Social Care Professions (HSCP). The primary aim of the unit is to improve the experience and outcomes of older adults aged ≥75 years that attend the ED. This is achieved by holistic interdisciplinary care underpinned by the principles of age-friendly healthcare systems and the 5Ms conceptual framework, coordination of an individualised care plan, and identification of alternative care options and pathways with the older adult.

 

BENEFITS:

The GEM Unit is governed by Emergency Medicine consultants enabling older adults stream to the unit direct from triage. The unit is operational 24/7 and the HSCP team have extended their working hours and are operational Monday-Friday, 08:00-20:00. The overall GEM Unit conversion rate of 42% % is 9.3% lower than the average national 75+ conversion rate of 51.3% (YTD). Based on empirical evidence this equates to significant cost savings. The team’s commitment to ongoing integration at the primary-secondary care interface is reflected in 30-day ED re-attendance data, where the figure has trended down from 19% in 2019 to 12% 2023 and 2024 YTD.

 

PROJECT CONTACT DETAILS:

Íde O’Shaughnessy

Email: idelouise.oshaughnessy@hse.ie

Phone: 087 6247668