The Impact of a Geriatric Multidisciplinary Team in the Emergency Department

Older adults represent a growing proportion of the population and frequently present to hospitals with complex medical, cognitive, functional, and psychosocial needs that require interdisciplinary management. They are also at heightened risk of functional decline when accessing health services, with delays in care coordination contributing to unnecessary hospitalizations and hospitalization-associated disability. Improving outcomes for this population requires proactive, collaborative mobilization of multidisciplinary teams at the time of presentation, rather than reactive or fragmented responses. To address this need, we established a Geriatric Multidisciplinary Team (Geri-MDT) dedicated to the emergency department (ED). The Geri-MDT includes a geriatric nurse, physiotherapist, occupational therapist, social worker, and geriatrician, who together provide early triage and coordinated care for older adults presenting to the ED. We hypothesized that early, well-coordinated involvement of this team would reduce ED length of stay, decrease unnecessary admissions, and shorten inpatient admissions when required.

Inclusion criteria

for the retrospective analysis were:

• evaluation by at least one allied health professional, including a geriatric nurse, geriatrician, physiotherapist, occupational therapist, or social worker;
• age 65 years or older; and
• availability of the medical record in the hospital's electronic medical record (EMR) system.

Exclusion criteria

(1) data not available in the EMR.

In the post-implementation period, patients were flagged for Geri-MDT assessment if they met any of the following criteria:

• age over 85 years,
• a score of ≥4 on the Program of Research to Integrate the Services for the Maintenance of Autonomy 7 (PRISMA-7) frailty screening tool, or
• an ED presentation related to a geriatric syndrome (e.g., fall, delirium, dementia, urinary incontinence, functional decline, or elder abuse).