Unplanned readmission prevention by a geriatric emergency network for transitional care (URGENT): a prospective before-after study

BMC Geriatr. 2019 Aug 7;19(1):215. doi: 10.1186/s12877-019-1233-9.

Abstract

Background: URGENT is a comprehensive geriatric assessment (CGA) based nurse-led care model in the emergency department (ED) with geriatric follow-up after ED discharge aiming to prevent unplanned ED readmissions.

Methods: A quasi-experimental study (sequential design with two cohorts) was conducted in the ED of University Hospitals Leuven (Belgium). Dutch-speaking, community-dwelling ED patients aged 70 years or older were eligible for enrolment. Patients in the control cohort received usual care. Patient in the intervention cohort received the URGENT care model. A geriatric emergency nurse conducted CGA and interdisciplinary care planning among older patients identified as at risk for adverse events (e.g. unplanned ED readmission, functional decline) with the interRAI ED Screener© and clinical judgement of ED staff. Case manager follow-up was offered to at risk patients without hospitalization after index ED visit. For inpatients, geriatric follow-up was guaranteed on an acute geriatric ward or by the inpatient geriatric consultation team on a non-geriatric ward if considered necessary. Primary outcome was unplanned 90-day ED readmission. Secondary outcomes were ED length of stay (LOS), hospitalization rate, in-hospital LOS, 90-day higher level of care, 90-day functional decline and 90-day post-hospitalization mortality.

Results: Almost half of intervention patients (404/886 = 45.6%) were categorized at risk. These received on average seven advices. Adherence rate to advices on the ED, during hospitalization and in community care was 86.1, 74.6 and 34.1%, respectively. One out of four at risk patients without hospitalization after index ED visit accepted case manager follow-up. Unplanned ED readmission occurred in 170 of 768 (22.1%) control patients and in 205 of 857 (23.9%) intervention patients (p = .11). The intervention group had shorter ED LOS (12.7 h versus 19.1 h in the control group; p < .001), but higher rate of hospitalization (70.0% versus 67.0% in the control group; p = .003).

Conclusions: The URGENT care model shortened ED LOS and increased the hospitalization rate, but did not prevent unplanned ED readmissions. A geriatric emergency nurse could improve in-hospital patient management, but failed to introduce substantial out-hospital case-management.

Trial registration: The protocol of this study was registered retrospectively with ISRCTN ( ISRCTN91449949 ; registered 20 June 2017).

Keywords: Comprehensive geriatric assessment; Emergency department; Geriatric care model; Nurse-led; Unplanned ED readmission.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Controlled Before-After Studies / methods
  • Controlled Before-After Studies / trends*
  • Emergency Medical Services / methods
  • Emergency Medical Services / trends*
  • Emergency Service, Hospital / trends
  • Female
  • Geriatric Assessment* / methods
  • Hospital Mortality / trends
  • Hospitals, University / trends
  • Humans
  • Male
  • Patient Discharge / trends
  • Patient Readmission / trends*
  • Prospective Studies
  • Retrospective Studies
  • Transitional Care / trends*

Associated data

  • ISRCTN/ISRCTN91449949