The ED geriatrician: a needs-analysis based on the ACEM-GEM framework.

In recent years the Australasian College for Emergency Medicine (ACEM) has developed frameworks for improving the quality of care delivered to older patients under the the ACEM-GEM (Geriatric Emergency Medicine) banner. This is in recognition of the ageing population and their increasingly complex health needs. The divide between the recommended ideal and the ‘real world’ ED is not well described. Literature on pragmatic measures to enable ‘closing the gap’ are also limited. ACEM has specific training for Paediatric Emergency Physicians but although having a body of emergency physicians with specialization in geriatrics is advocated, there is no training scheme for this. Employment of RACP-trained geriatricians in EDs may be a valuable ‘bridge’ but roles and scope of practice are undefined. Stage 1: Literature search and summary on geriatrician involvement in the ED. Stage 2: Retrospective audit to identify the size and characteristics of the likely local relevant patient subgroup. This will need a QA ethics submission. Stage 3: Conduct of a local ‘needs analysis’ against ACEM recommendations and literature findings and the size/type of the local relevant population Stage 4: Formulation of a trial geriatrician role description based on the needs analysis, including a cost analysis (outlay versus potential savings due to quality improvements). This would involve conduct of key-stakeholder workshops (ED, geriatrician, allied health, consumers). Stage 5: Protocol development for a pre and post-intervention evaluation of a temporary geriatrician position ED in order to seek both funding and ethics approval. The 2023 project would conclude at this point.