AGEM Author Spotlight Nov 2021

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Published Work by AGEM Members

AGEM Author Spotlight: Maura Kennedy, MD Division Chief of Geriatric Emergency Medicine, Assistant Professor of Emergency Medicine at Harvard Medical School

Reach and Adoption of a Geriatric Emergency Department Accreditation Program in the United States

Kennedy, Maura, et al. "Reach and adoption of a geriatric emergency department accreditation program in the United States." Annals of Emergency Medicine (2021).

https://doi.org/10.1016/j.annemergmed.2021.06.013

Article Summary: This is an article analyzing a cross-section of a cohort of 225 US emergency departments (EDs) that received geriatric emergency department accreditation (GEDA) from May 2018 to March 2021. The study analyzed aggregate data from the GEDA database for ED applications and approvals to determine trends. Results showed the vast majority of approved geriatric EDs were level 3 (84%) and the most common reason cited for applying was improving care delivery to older adults. The median annual ED visit volume was 37,044 (IQR 22,545 to 59,233) and the most common geriatric care processes adopted were related to addressing geriatric falls (90/225, 40%), minimizing urinary catheter use (87/225, 39%), identifying elder abuse (53/225, 24%), addressing delirium (49/225, 22%), and identifying assessment of function and functional decline (47/225, 21%). Only 4% of geriatric EDs were in rural regions while nearly one fifth of all ED visits occurred in a rural setting. There has been rapid growth in accredited geriatric EDs in the US and additional research is needed on the impact of GEDA on health care utilization and patient-oriented outcomes.

Why geriatric emergency medicine?:

My clinical and research expertise focuses on the care of patients with acute and chronic cognitive impairment in older adults in the emergency department (ED), as well as evaluation of care processes designed to improve the care of older ED patients. My first interest in cognitive impairment in the ED setting stemmed from research that demonstrated altered mentation was the third most common reason for floor-to-ICU transfer of septic ED patients and septic ED patients with altered mentation had a 3-fold increase in mortality. This finding spurred subsequent my subsequent research into ED delirium, including a prospective study in which I developed a risk profile identifying patients at high risk of being delirious in the ED; older adults with dementia had a 4-fold greater odds of being acutely delirious in the ED setting. During the COVID-19 pandemic, I participate in a multicenter study that demonstrated that 28% of older older ED patients with COVID-19 infection had delirium. More recently I have collaborated with other experts in geriatric emergency medicine in descriptive research of accreted geriatric emergency departments. I have also served as the emergency physician representative on the American Geriatrics Society Expert Panel on Postoperative Delirium, was on the working group that created the ADEPT tool, a rapid reference tool designed to help emergency physicians optimally care for agitated and delirious older ED patients, and was a content expert for the ED Delirium Toolkit Project, a project focused on improving the care of ED patients with or at risk for delirium.

Bio:

Maura Kennedy is the chief of the division of Geriatric Emergency Medicine at Massachusetts General Hospital and assistant professor of emergency medicine at Harvard Medical School. She is also the past-presented of the Academy of Geriatric Emergency Medicine, president-elect for the geriatric emergency medicine section at ACEP and serve on the board of governors for ACEP's Geriatric Emergency Department Accreditation program.

Twitter Handle @MauraKennedyMD

Previous AGEM Author Spotlight Articles

October 2021

Effectiveness of a care transitions intervention for older adults discharged home from the emergency department: A randomized control trial

Jacobsohn GC, Jones CMC, Green RK, Cochran AL, Caprio TV, Cushman JT, Kind AJH, Lohmeier M, Mi R, Shah MN (2020). Academic emergency medicine : official journal of the Society for Academic Emergency Medicine https://doi.org/10.1111/acem.14357

February 2020

GAPcare: The Geriatric Acute and Post-Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data.
Goldberg EM, Marks SJ, Ilegbusi A, Resnik L, Strauss DH, Merchant RC.
J Am Geriatr Soc. 2020 Jan;68(1):198-206. doi: 10.1111/jgs.16210. Epub 2019 Oct 17.
PMID: 31621901

January 2020

Concepts in Practice: Geriatric Emergency Departments.

Southerland LT, Lo AX, Biese K, Arendts G, Banerjee J, Hwang U, Dresden S, Argento V, Kennedy M, Shenvi CL, Carpenter CR. Ann Emerg Med. 2020 Feb;75(2):162-170.

November 2019

Association of Emergency Clinicians' Assessment of Mortality Risk With Actual 1-Month Mortality Among Older Adults Admitted to the Hospital.
Ouchi, K. et. al. (2019) JAMA Network Open.

August 2019

Managing the Elderly Emergency Department Patient
Shenvi, C. L., & Platts-Mills, T. F. (2019) Annals of Emergency Medicine.

February 2019

Exploring Older Adult ED Fall Patients' Understanding of Their Fall: A Qualitative Study.
Shankar KN, Taylor D, Rizzo CT, Liu SW. Geriatric Orthopaedic Surgery & Rehabilitation. 2017 Dec;8(4):231-237

November 2018
Common Medication Management Approaches for Older Adults in the Emergency Department.
Dresden SM, Allen K, Lyden AE. Clinics in Geriatric Medicine. 2018 Aug;34(3):415-433

April 2018
Telephone Followâ€Up for Older Adults Discharged to Home from the Emergency Department: A Pragmatic Randomized Controlled Trial
Biese KJ, Busby-Whitehead J, Cai J, Stearns SC, Roberts E, Mihas P, Emmet D, Zhou Q, Farmer F, Kizer JS.Journal of the American Geriatrics Society. 2018 March; 66(3): 452-458

March 2018
An Emergency Department Observation Unit Is a Feasible Setting for Multidisciplinary Geriatric Assessments in Compliance With the Geriatric Emergency Department Guidelines
Southerland LT, Vargas AJ, Nagaraj L, Gure TR, Caterino JM. Academic Emergency Medicine. 2018 Jan; 25(1): 76-82

February 2018
Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use
Hwang U, Dresden SM, Rosenberg MS, Garrido MM, Loo G, Sze J, Gravenor S, Courtney DM, Kang R, Zhu CW, Vargas-Torres C, Grudzen CR, Richardson LD; GEDI WISE Investigators

January 2018

Major trauma in the older patient: Evolving trauma care beyond management of bumps and bruises
Carpenter CR, Arendts G, Hullick C , Nagaraj, Cooper Z, Burkett E

December 2017

Emergency Department Pain Management Following Implementation of a Geriatric Hip Fracture Program
Casey SD, Stevenson DE, Mumma BE, Slee C, Wolinsky PR, Hirsch CH,Tyler K

November 2017

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse
Rosen T; Lien C, Stern ME, Bloemen EM, Mysliwiec R, McCarthy TJ, Clark S, Mulcare MR, Ribaudo DS, Lachs MS, Pillemer K, Flomenbaum NE

October 2017

Discrepancies between information provided and information required by emergency physicians for long-term care patients
Evans CS; Timothy Platts-Mills, MD, MSc; Fernandez AR; Grover JM; Cabanas JG; Patel MD; Vilke GM; Brice JH

September 2017

Discrepancies between information provided and information required by emergency physicians for long-term care patients
Parshar R, McLeod S,Don Melady, MSc, MD,

August 2017

The Effect of Older Age on EMS Use for Transportation to an Emergency Department
Manish N. Shah, MD, MPH; Jones CMC; Wasserman EB, Li T, Amidon A, Abbot, M

July 2017

Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study
Shan W. Liu MD, SD; Jiraporn Sri-On MD, Gregory Philip Tirrell MS, Christian Nickel MD, Roland Bingisser MD

June 2017

Accuracy of Current Diagnostic Criteria for Acute Bacterial Infection in Older Adults in the Emergency Department
Jeffrey Caterino, MD; Robert Leininger, MD; David M. Kline, PhD; Lauren T. Southerland, MD; Salman Khaliqdina, MBBS; Christopher W. Baugh, MD, MBA; Daniel J. Pallin, MD, MPH; Kurt B. Stevenson, MD, MPH

May 2017

Factors Associated with Hospital Admission for Older Adults Receiving Care in U.S. Emergency Departments
Alexander X. Lo, MD, PhD; Kellie L. Flood, MD; Kevin Biese, MD, MAT; Timothy F. Platts-Mills, MD, MSc; John P. Donnelly, MSPH; Christoper R. Carpenter, MD, MS

April 2017

Emergency Department Visits Without Hospitalization Are Associated With Functional Decline in Older Persons
Justine M. Nagurney, MD; William Fleischman, MD, MHS; Ling Han, MD, PhD; Linda Leo-Summers, MPH, Heather G. Allore, PhD; Thomas M. Gill, MD

Improving Pain Relief in Elder Patients (I-PREP): An Emergency Department Education and Quality Intervention
Teresita M. Hogan, MD; Michael D. Howell, MD; John F. Cursio, PhD; Alexandra Wong, BA; William Dale, MD

March 2017

Exploring Delirium's Heterogeneity: Association Between Arousal Subtypes at Initial Presentation and 6-Month Mortality in Older Emergency Department Patients
Jin H. Han, MD, MSc; Nathan E. Brummel, MD, MSCI; Rameela Chandrasekhar, PhD; Jo Ellen Wilson, MD; Xulei Liu, MS; Eduard E. Vasilevskis, MD, MPH; Timothy D. Girard, MD, MSCI; Maria E. Carlo, MD; Robert S. Dittus, MD, MPH; John F. Schnelle, PhD; E. Wesley Ely, MD, MPH

December 2016

Feasibility of nurses measuring gait speed in older community-dwelling Emergency Department patients
Paula W. Tucker, DNP, FNP-BC; Dian Dowling Evans, PhD, FNP-BC, ENP-BC, FAANP; Carolyn K. Clevenger, DNP, RN, GNP-BC, AGPCNP-BC, FAANP; Michelle Ardisson, DNP, RN, ACNP-BC; Ula Hwang, MD, MPH, FACEP

October 2016

Effect of Geriatric-Specific Trauma Triage Criteria on Outcomes in Injured Older Adults: A Statewide Retrospective Cohort Study
Jeffrey M. Caterino, MD, MPH; Nicole Brown, MS; Maya W Hamilton, BA; Brian Ichwan, MD; Salman Khaliqdina, MBBS; David C. Evans, MD; Subrahmanyan Darbha, MS; Ashish R. Panchal, MD, PhD; Manish N. Shah, MD, MPH

October 2013

Geriatric Department Guidelines
Mark S. Rosenberg, DO, MBA, FACEP, Christopher R. Carpenter, MD, MSc, FACEP, Marilyn Bromley, RN, BS, Jeffrey M. Caterino, MD, MPH, FACEP, Audrey Chun, MD, Lowell Gerson, PhD, Jason Greenspan, MD, FACEP, Ula Hwang, MD, FACEP, David P. John, MD, FACEP, Joelle Lichtman, MA, William L. Lyons, MD, Betty Mortensen, RN, MS, BSN, FACHE, Timothy F. Platts-Mills, MD, MSc, Luna C. Ragsdale, MD, MPH, FACEP, Julie Rispoli, David C. Seaberg, MD, CPE, FACEP, Scott T. Wilber, MD, MPH, FACEP