VA enhances geriatric emergency care for older Veterans

WASHINGTON — The Department of Veterans Affairs launched a Geriatric Emergency Department initiative within all of VA’s 18 Veterans Integrated Service Networks through a standardized, comprehensive care model, becoming the nation’s largest integrated health network with specialized geriatric emergency care.

This initiative equips VA emergency departments with the ability to treat older Veterans with complex conditions, catch unmet care needs and develop teamwork strategies throughout VA to better coordinate ED and follow-up care.

VA has partnered with the American College of Emergency Physicians, The John A. Hartford Foundation and the West Health Institute to ensure elderly Veterans continue to be afforded the best possible emergency care and person-centered health services. .

The evidence-based approach to caring for older adults includes screenings to identify seniors at risk for cognitive impairment, delirium, fall risk, functional decline, and caregiver burden.

“Nearly half of the nation’s 19.5 million Veterans are over 65 years old and account for more than 45% of ED visits at VA hospitals— more than double the rate for seniors nationwide,” said VA Acting Under Secretary for Health Steven L. Lieberman, M.D. “Our goal is to lower this number by ensuring VA’s elderly population receives age-friendly emergency care, while improving care coordination in communities across the nation.”

VA continues to promote and augment transitions of care through an interdisciplinary team approach from various services throughout facilities. This is achieved through connecting with social work and VA home/community resources, geriatric education for emergency department staff and supporting geriatric Veterans in the community to prevent avoidable admissions.

The partnership aims to establish 70 VA emergency departments as geriatric EDs eligible for accreditation in alignment with ACEP’s GED Accreditation by December 2022.

Accreditation includes three levels that each have specific education criteria for clinicians and nurses, creating EDs that are more expertly equipped to treat older Veterans with complex conditions and social needs through interdisciplinary service coordination across a hospital.

To date, there are 16 VA sites between levels 1 and 3, with level 1 accreditation being the highest achievable and most rigorous level:

• Cleveland, Ohio (1)
• Louisville, Ky. (2)
• Atlanta, Ga. (2)
• Buffalo, N.Y. (2)
• Durham, N.C. (2)
• Syracuse, N.Y. (2)
• Palo Alto, Calif. (3)
• Charleston, S. C. (3)
• New Orleans, La. (3)
• Grand Junction, Colo. (3)
• Greater Los Angeles, Calif. (3)
• San Diego, Calif. (3)
• Madison, Wis. (3)
• Long Beach, Calif. (3)
• West Haven, Conn. (3)
• Salt Lake City, Utah (3)

Accredited emergency departments have proven to lower costs, reduce the rate of unnecessary hospital admissions, and prevent the risk of inpatient complications. Best practices and lessons learned from this collaboration will be shared with EDs outside the VA. ACEP has accredited more than 200 emergency departments since the program’s inception in 2018.