A Scarce Resource: Cleveland Clinic’s Innovative Geriatric ED Reduces Avoidable Admissions
The Geriatric Emergency Department (GED) initiative by Cleveland Clinic aims to address the unique and complex needs of older adult patients in emergency settings, who often experience higher rates of admission and longer hospital stays due to the traditional ED model’s focus on acute needs versus chronic. Recognizing the challenges posed by high census and bed shortages, the GED model has been implemented across all 13 Cleveland Clinic EDs to prioritize the most vulnerable patients by improving care efficiency and patient outcomes. This includes standardized care protocols, early detection of delirium, and seamless transitions of care, ensuring that only patients with the highest acuity are admitted, while others are safely transitioned back to their homes.
The GED model incorporates various operational frameworks, such as dedicated geriatric units and the use of geriatric practitioners, to enhance the management of geriatric syndromes and reduce unnecessary admissions. Specifically, the inclusion of geriatric physicians in the observation units has significantly lowered avoidable admissions by streamlining the care process and utilizing existing resources more effectively. These measures have not only improved throughput in the ED but have also facilitated additional professional billing opportunities and decreased the overall impact on ED operations, showcasing a scalable model for geriatric care.
Economically, the GED program has been impactful, yielding substantial cost savings through reduced Medicare expenditures and minimized length-of-stay for admitted patients. An analysis of patient outcomes from the GED units compared to traditional care shows a marked decrease in admission rates and associated costs, saving millions in avoidable hospital expenses annually. The program also enhances revenue through direct billing for geriatric services and increased referrals to outpatient clinics, underpinning a comprehensive approach to geriatric emergency care that balances clinical excellence with cost efficiency. This initiative not only underscores Cleveland Clinic’s commitment to innovative healthcare solutions but also sets a benchmark for the integration of geriatric care into emergency medicine nationally.
