Dedicated Older People’s ED reduces waiting times, according to new NNUH research
The formation of the country’s first Older People’s Emergency Department (OPED) has led to a signification decrease in the time spent in A&E and a small reduction in patients being admitted, according to new research.
The first OPED in England was opened at our Trust in December 2017 to bring older people’s medicine specialists to the front doors of the hospital and provide earlier assessment and treatment for patients over the age of 80.
Research published in the Journal of Emergency Medicine evaluated outcomes of a patients who received treatment in the main Emergency Department of NNUH and a similar group of patients who were seen in OPED. The cohort consisted of two separate sets of patients aged 80 years and older attending NNUH’s ED on Saturdays and Sundays between 9am and 5pm in the following months.
- Randomly selected historical controls: 1 July 2019 to 1 November 2019 seen by any ED clinician
- OPED Intervention: 1 July 2020 to 1 November 2020 seen by OPED staff.
The team found that patients spent 20% less time in OPED and patients received a frailty assessment on average within 34 minutes of arrival, compared with 75 minutes in ED.
As a result of seeing an older people’s medicine specialist earlier, there were proportionally fewer admissions from the OPED (46.1%) compared with the main ED (50.3%), although this difference was not statistically significant.
Dr Katharina Mattishent, Consultant in Older People’s Medicine at NNUH and Clinical Lecturer at Norwich Medical School, UEA, said: “We have demonstrated that patients seen in our environmentally modified area of the ED, led by Consultant Geriatricians, were three times more likely to meet the four-hour national target compared with those seen in the main ED. 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 ED 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