Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 May 8;5(3):e13182.
doi: 10.1002/emp2.13182. eCollection 2024 Jun.

Enhancing healthcare access for an older population: The age-friendly emergency department

Sangil Lee  1 , Rachel M Skains  2   3 , Phillip D Magidson  4 , Nadine Qadoura  1 , Shan W Liu  5 , Lauren T Southerland  6
Affiliations
Review

Enhancing healthcare access for an older population: The age-friendly emergency department

Sangil Lee et al. J Am Coll Emerg Physicians Open. .

Abstract

Healthcare systems face significant challenges in meeting the unique needs of older adults, particularly in the acute setting. Age-friendly healthcare is a comprehensive approach using the 4Ms framework-what matters, medications, mentation, and mobility-to ensure that healthcare settings are responsive to the needs of older patients. The Age-Friendly Emergency Department (AFED) is a crucial component of a holistic age-friendly health system. Our objective is to provide an overview of the AFED model, its core principles, and the benefits to older adults and healthcare clinicians. The AFED optimizes the delivery of emergency care by integrating age-specific considerations into various aspects of (1) ED physical infrastructure, (2) clinical care policies, and (3) care transitions. Physical infrastructure incorporates environmental modifications to enhance patient safety, including adequate lighting, nonslip flooring, and devices for sensory and ambulatory impairment. Clinical care policies address the physiological, cognitive, and psychosocial needs of older adults while preserving focus on emergency issues. Care transitions include communication and involving community partners and case management services. The AFED prioritizes collaboration between interdisciplinary team members (ED clinicians, geriatric specialists, nurses, physical/occupational therapists, and social workers). By adopting an age-friendly approach, EDs have the potential to improve patient-centered outcomes, reduce adverse events and hospitalizations, and enhance functional recovery. Moreover, healthcare clinicians benefit from the AFED model through increased satisfaction, multidisciplinary support, and enhanced training in geriatric care. Policymakers, healthcare administrators, and clinicians must collaborate to standardize guidelines, address barriers to AFEDs, and promote the adoption of age-friendly practices in the ED.

Keywords: age‐friendly; care transitions; emergency department; multidisciplinary collaboration.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Specific ways in which the 4Ms framework applies to emergency department care.
FIGURE 2
FIGURE 2
Medication management among older adults in the emergency department.
FIGURE 3
FIGURE 3
Care transitions within the age‐friendly health system.
See this image and copyright information in PMC

References

    1. Cairns C, Kang K. National Hospital Ambulatory Medical Care Survey: 2020 Emergency Department Summary Tables. Centers for Disease Control and Prevention. 2022. doi:10.15620/cdc:121911 - DOI
    1. Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55(5):780‐791. doi:10.1111/j.1532-5415.2007.01156.x - DOI - PMC - PubMed
    1. Aminzadeh F, Dalziel WB. Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med. 2002;39(3):238‐247. doi:10.1067/mem.2002.121523 - DOI - PubMed
    1. Carpenter CR, Bromley M, Caterino JM, et al. Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society. Acad Emerg Med. 2014;21(7):806‐809. doi:10.1111/acem.12415. Emergency Nurses Association, and Society for Academic Emergency Medicine. - DOI - PubMed
    1. American College of Emergency Physicians . Home | Geriatric Emergency Department Accreditation. Geriatric Emergency Department Accreditation. Accessed July 20, 2023. https://www.acep.org/geda/