Geriatric Emergency Department Accreditation

The geriatric emergency department concept was developed by leaders in emergency medicine to ensure that our older patients receive well-coordinated, quality care at the appropriate level at every emergency department encounter. ACEP’s Geriatric Emergency Department Accreditation program (GEDA) is leading the charge towards standardizing the care of these complex patients who often present to the ED with multiple medical problems.

In the spring of 2018, ACEP began accrediting geriatric EDs. To date, accreditation has been granted to 40 hospitals, with more than 190 United States EDs in the pipeline. Having a geriatric ED does not mean creating a separate space for these patients, but rather processes specific to their needs (such as screening for geriatric syndromes,) structural enhancements (such as appropriate ED beds and dimmed lights,) provider and nurse education, and community resources to facilitate care for older adults. The program can work for any hospital from the smallest, rural ED to a large, urban center with a separate GED space and is voluntary.

Dr. Kevin Biese, co-director of geriatric emergency medicine at the University of North Carolina School of Medicine and chair of the ACEP program, stated, “Geriatric EDs aren't new concepts. Hospitals were thinking of this stuff already, but it was like sculpting fog … The accreditation program really is an empowering tool to get the resources to do it more formally.”

Accreditation is provided at three levels. Level 1 is the most comprehensive designation. Levels 2 and 3 require the EDs to have at least one geriatric-trained physician and nurse, just as the Level 1 requirement calls for, but less reporting requirements and stipulations. The accreditation process provides more than two dozen best practices for geriatric care. An ED can determine the level it wishes to achieve depending on the number of best practices it strives to meet. Criteria (based on the Geriatric Emergency Department Guidelines) and goals are provided for each level with specialized education in the eight domains of geriatric EM. The geriatric ED must also meet specific environmental criteria, including easy patient access to food, water, and mobility aids, as well a minimum of one geriatric-specific emergency care initiative.

The benefits of accreditation are three-fold:

• For hospitals, increased brand recognition and market share.
• For providers, access to resources and services, such as walkers and social services.
• Physician and hospital administration alignment towards improving care.

Additional information about GEDA

Nicole Tidwell
Geriatric Emergency Department Accreditation Program Director