Dedicated older people's emergency department found to reduce wait times

The formation of the country's first emergency department for the over 80s led to a significant decrease in time spent in A&E—according to research from the Norfolk and Norwich University Hospital (NNUH) and University of East Anglia (UEA).

The first Older People's Emergency Department in England was opened at NNUH in December 2017 to bring specialists in older people's medicine to the front doors of the hospital and provide earlier assessment and treatment for patients.

A new study evaluates the outcomes for patients who received treatment in the main emergency department at NNUH and a similar group of patients who were seen in the Older People's Emergency Department.

As well as reducing wait times for the elderly, the initiative also led to a small reduction in patients being admitted to hospital.

The team found that patients dealt with under the new initiative spent 20 percent less time in the older people's emergency department. They also received a frailty assessment on average within 34 minutes of arrival, compared with 75 minutes in the regular emergency department.

As a result of seeing an older people's medicine specialist earlier, there were proportionally fewer admissions from the older people's emergency department (46.1 percent) compared with the main emergency department (50.3 percent), although this difference was not statistically significant.

Dr. Katharina Mattishent, Consultant in Older People's Medicine at NNUH and Clinical Lecturer at UEA's Norwich Medical School, said, "We have demonstrated that patients seen in our environmentally modified area of the emergency department, led by Consultant Geriatricians, were three times more likely to meet the four-hour national target compared with those seen in the main emergency department."

"This is an important finding, as increased wait times are associated with increased inpatient length of stay, mortality, hospital admissions, and functional decline in those with cognitive impairment."

"A dedicated service in the emergency department can shorten the waiting times for clinical assessment of older people, but it is not clear that this leads to any downstream benefits in reducing likelihood of hospital admission for older patients."

"Evaluation of first Older People's Emergency Department in England—a retrospective cohort study" is published in the Journal of Emergency Medicine.