Accredited geriatric emergency departments continue to grow within VA hospitals

The Department of Veterans Affairs adopts new standards and approaches for treating older Veterans during and after a medical crisis

2023-04-19

(Press-News.org) WASHINGTON, D.C.—April 19, 2023—The U.S. Department of Veterans Affairs (VA), the largest integrated healthcare system in the nation, today announced that 60 of its 111 emergency departments have earned Geriatric Emergency Department Accreditation (GEDA) from the American College of Emergency Physicians (ACEP). Another 11 departments are on track to earn the designation in coming months and the VA has plans to expand the program to the majority of its hospitals over the next three years.

Geriatric emergency departments provide specialized care to older veterans and their families during and after a medical crisis. Many older adults have clinical and social needs that could make them more vulnerable to medical emergencies that may not be adequately addressed in traditional emergency departments. According to the VA, nearly half the nation’s 19.5 million veterans are over 65 years old and accounted for more than 50% of the over two million visits to VA emergency departments in 2022.

Recognizing the need to transform and standardize emergency care for older veterans, the VA began the Geriatric Emergency Department (GED) initiative in 2019 in partnership with ACEP, the West Health Institute and The John A. Hartford Foundation—two nonprofits dedicated to improving care for older adults—and the Indiana Institute of Medical Research (IIMR), one of VA’s internal nonprofit partners.

“We are committed to providing the best care possible for our Veterans and their families wherever they live, and the expansion of our geriatric emergency department program is but the latest demonstration of our effort to enduring commitment and best practices driving innovation,” said Erica Scavella, MD, Assistant Under Secretary for Health for Clinical Services and Chief Medical Officer of the Veterans Health Administration. “The response from both patients and staff to the GEDs has been very positive, and we will continue to improve and expand on the program to fit their growing and urgent needs.”

In the GED care model, interdisciplinary teams engage in more than two dozen best practices covering triage, screening, evaluation, treatment, discharge, the physical environment and surroundings, and the coordination of essential community social and health services after discharge. Within the VA, GEDs have seen improvements in care, fewer instances of polypharmacy, and more follow-up with primary care services following a visit.

“The GED movement is in full swing throughout the nation and geriatric emergency care is becoming more and more available to seniors and their families,” said Shelley Lyford, CEO and Chair of West Health. “The VA, through its leadership and adoption of GEDs, is fueling even further expansion of this important model of care for older patients both inside and outside the VA.”

Seniors are more likely than any other age group to make a visit to the emergency department, a trend that is only expected to grow with the aging of America. Currently, 16.5% of the U.S. population, or 54 million people, are 65 or older, according to the latest U.S. Census. By 2030, that number is expected to rise to 74 million, accounting for about 20% of the population.

“As a system, the VA serves a patient population predominately comprised of older adults and recognizes the importance of tailoring care rather than a one size fits all approach. This is particularly important in the ED where older adults present with complex health, social and caregiving challenges that might not be fully addressed in other emergency room settings,” said Christopher Kang, MD, FACEP, President, American College of Emergency Physicians. “We’re excited that the VA recognizes the urgent need, and we look forward to a continued collaboration that will benefit millions of Veterans for years to come.”

The American College of Emergency Physicians established its Geriatric Emergency Department Accreditation Program in 2018 in response to growing evidence that emergency departments have difficulties meeting the healthcare needs of older adults, who often have multiple chronic conditions and require social support. West Health and The John A. Hartford Foundation provided financial support and foundational work for the program.

Currently, there are more than 400 accredited GEDs nationwide. As a system serving a patient population of mostly older adults, the VA supports the ongoing development of best practices in geriatric care as a model for national health systems facing a growing older adult population.

“The rapid expansion of Geriatric Emergency Departments is great news for older Veterans who will gain more access to evidence-based care focused on what matters most to them as they age,” said Terry Fulmer, PhD, RN, FAAN, President of The John A. Hartford Foundation. “This is only one example of how the VA is leading the way in becoming the largest Age-Friendly Health System in the U.S.”

About American College of Emergency Physicians (ACEP)

The American College of Emergency Physicians (ACEP) is the national medical society representing emergency medicine. Through continuing education, research, public education, and advocacy, ACEP advances emergency care on behalf of its 40,000 emergency physician members, and the more than 150 million people they treat on an annual basis. For more information visit www.acep.org and www.emergencyphysicians.org.

About The John A. Hartford Foundation

The John A. Hartford Foundation, based in New York City, is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. The leader in the field of aging and health, the Foundation has three priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care. For more information, visit johnahartford.org and follow @johnahartford.

About West Health

Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations including the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego, and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org and follow @WestHealth.

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Accredited geriatric emergency departments continue to grow within VA hospitals

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