ED transitional care nurse program reduces hospitalizations by 33%

An emergency department (ED)-based transitional care nurse (TCN) program, focusing on geriatric care, was able to reduce the number of unnecessary hospitalizations by 33 percent. Findings were published in the Journal of the American Geriatrics Society.

This study used the Geriatric Emergency Department Innovations in Care through Workforce, Informatics, and Structural Enhancements (GEDI WISE) program to evaluate and reduce the number of unnecessary hospital admissions after a visit to the ED.

“With this program, we have created an otherwise non-existent safety net for this vulnerable population,” said Scott Dresden, MD, co-author of the paper and assistant professor of emergency medicine at Northwestern University Feinberg School of Medicine. “We wanted to ensure that we weren’t just discharging older patients from the emergency department only to be hospitalized again relatively quickly after something preventable like a fall.”

The study included 57,287 patients over 65 who had made 120,221 ED visits from January 1, 2013, to June 30, 2015. Data on inpatient admission during ED visits, 30-day admission and 72-hour ED revisits were collected.

Overall 5,930 individuals were seen by TCN, of which 42 percent were admitted. Results showed patients coming in contact with TCN had a lower risk of admission and lower rates of 30-day admission while 72-hour ED revisits were more common in TCN groups.