VA emergency departments ready for growing population of older Veterans

With more than half of all VA emergency department visits involving a Veteran over the age of 65, VA is continuing to build on its recent efforts to become the largest specialized geriatric emergency care provider in the U.S.

Since starting this initiative in 2019, VA now has 67 accredited geriatric emergency departments (GED) spread out across the country with 18 more in process over the next few years. Being GED accredited means that staff are dedicated to the unique needs of an increasingly geriatric Veteran population.

“Approximately half of U.S. Veterans are over 65 years old, and we know that older adults often have clinical and social needs that are outside what we see during a routine emergency department visit,” said Dr. Neil Patel, deputy executive director for the National Emergency Medicine Office. “By making sure we not only provide the acute medical care they need but also matching them with both VA and community resources is a huge part of being Veteran-centric.”

With older patients, we ask about other health conditions.

The American College of Emergency Physicians (ACEP) offers three levels of GED accreditation, with Level 1 being the most comprehensive care model. Accreditation is based on providing four to twenty best practices covering screening, evaluation, treatment, environment of care and transition of care, including coordination of VA and community social and health services after discharge.

“When someone comes to the emergency department, we are focused on the issue that brought them to us. But with our older patients, we also ask about their other health conditions in case we can help them schedule an appointment within VA or refer them to a community program that could help them. VA has so many services, we are really making a point to help these Veterans get the care they need and deserve,” Patel said.

“This public-private collaboration between VA, ACEP, The John A. Hartford Foundation and the West Health Institute to create accredited geriatric emergency departments is designed to create welcoming emergency departments that offer multi-disciplinary, specialized care that is focused on at-risk older Veterans,” said Dr. Chad Kessler, executive director for the National Emergency Medicine Office. “Through the accreditation process, we’ve learned about specialized geriatric resources available within VA and in our community, making sure our Veterans leave with not only their medical needs met but resources to help with their social needs and overall wellbeing.”

Pilot project saw significant improvements

The initial VA pilot project in the emergency department at the Louis Stokes Cleveland VA Medical Center saw significant improvements in care and outcomes for older Veterans.

“Robust geriatric emergency department programs allow us to fulfil Veterans’ wishes to age safely at home by connecting them and their families to age-appropriate services and caregiver support programs. From an operations standpoint this equates to decreased hospital admissions and inpatient bed days,” said Dr. Colleen McQuown, director of Supporting Community Outpatient Urgent Care and Telehealth Services, or SCOUTS, a geriatric emergency department transition program. “We’ve always provided high quality care in our emergency departments, but this focus on identifying what matters to our most vulnerable older Veterans and addressing their unmet needs and geriatric syndromes really makes a positive impact on their lives. You can see the relief in their faces when I tell them ‘We have a plan to take care of your health and get you home today.’”