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Table 1 GEDI team responsibilities

From: A structure, process and outcome evaluation of the Geriatric Emergency Department Intervention model of care: a study protocol

GEDI Clinical Nurse Consultant

GEDI Clinical Nurse

GEDI Physician

Clinical responsibilities

 ▪ Collaborative partnership with physician-champion to develop evidenced based guidelines specific to the needs of the geriatric patients and clinicians in the ED

▪ Works collaboratively with all ED staff

▪ Clinical resource and expert in geriatric emergency medicine

 ▪ Develops and maintains enhanced communication strategies related to ED staff, RACF staff, Nurse Practitioner (NP), community services, paramedic staff and general medical practitioners (GPs).

▪ Enhanced communication by providing a dedicated single point of contact within the ED for RACF staff, NP, community services, paramedics and GPs to obtain support and advice regarding optimal care and management of acutely unwell or injured frail older person or RACF resident

▪ Facilitates interdisciplinary discussions and establishes clinical hospital wide networks

 ▪ Develops and upskills CNs in use of rapid assessment of frail older persons or RACF residents

▪ Rapid assessment and management of frail older persons or RACF resident including nurse initiated analgesia and investigations

▪ Identify information to be sourced by the GEDI CN relevant to ED medical officers

 ▪ Develops evidence based clinical care algorithms for common problems experienced by RACF residents within the ED

▪ Provides evidence based clinical care for older persons in the ED in collaboration with the primary nurse

▪ Provide education for emergency staff, promoting informed decision making and best practice

 ▪ Provision of a consultative service for patient centred care of the frail older person or RACF resident within the ED

▪ Provision of a consultative service for patient centred care of the frail older person or RACF resident within the ED

 

 ▪ Develops systems and upskills CNs to undertake direct referral to Geriatricians and rapid consultation pathways with other medical service streams

▪ Direct referral to Geriatricians and rapid consultation pathways with other medical service streams

 

 ▪ Develops systems to facilitate pre-hospital communication with the RACF, GP, NP and Ambulance service, facilitating appropriate transfer decision making and early arrival triage

▪ Pre-hospital communication with the RACF, GP, NP and Ambulance service, facilitating appropriate transfer decision making and early arrival triage

 
 

▪ Liaison with hospital acute-care substitution services such as the Hospital in The Home and palliative care services

 

Administrative responsibilities

 ▪ Collaborative partnership with physician-champion to manage the GEDI team and GEDI CN portfolios

▪ Facilitation of discharge back to place of residence or admission – i.e. appropriate disposition planning

▪ Implement MOC and promote care of the older persons in ED

 ▪ In collaboration with GEDI Physician and university partners coordinate a program of research focused on the care of older persons in ED

▪ Ensuring discharge summaries are provided to all care providers e.g. GPs, RACF, primary carers, community services following acute ED care to allow seamless transition of care

▪ Create and edit clinical pathways and guidelines for best practice i.e. Delirium management

 ▪ Coordinate the aged care component of the ED staff development program in consultation with GEDI CNs and ED Nurse Educator

▪ Provide education for ED staff in evidence based care of the frail older person or RACF resident

▪ Leader in change management and lean thinking strategies

 ▪ Coordinate NP clinical practicum in the ED for NP candidates specialising in care of the frail older person or RACF resident to enhance skill base and knowledge of the ED setting. Skills obtained are translated into practice within the aged care service setting.

▪ Facilitate education/clinical exposure in the ED for NP candidates specialising in care of the frail older person or RACF resident to enhance skill base and knowledge of the ED setting.

▪ Negotiation of resource use in the ED

 

▪ Establishment of rapid, direct referral pathways to specialised geriatric and palliative care departments

▪ Champion the GEDI model in strategic planning with senior staff and hospital administration

  

▪ Collaborate and maintain research relationships

  

▪ Participate in research and program audits

  

▪ Administrator of GEDI team and budget

  

▪ Collaborate with national and international geriatric focus groups

  

▪ Liaise with other program directors/coordinators