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1. The Geriatric Emergency Care Applied Research (GEAR) network approach: a protocol to advance stakeholder consensus and research priorities in geriatrics and dementia care in the emergency department

Author

Shan Liu, John Morris, Cynthia Brandt, Eric Isaacs, Lynne Richardson, David Carr, Kathleen Kelly, Marian Betz, Jon Mark Hirshon, Maria Raven, Jin Han, Maura Kennedy, Manish Shah, Andrea Gilmore-Bykovskyi, Sunday Clark, Kevin Biese, Adriane Lesser, Kelly Ko, Mark Rosenberg, Ula Hwang, Christopher Carpenter, Ryan Carnahan, Susan Hastings, Daniel Wei, Vincent Mor, Denise Nassisi, William Perry, Connor Sullivan, Scott Dresden, Jeffrey Dussetschleger, Angela Gifford, Ly Hoang, Jesseca Leggett, Armin Nowroozpoor, Zachary Taylor, M Fernando Bellolio, Christine Binkley, Nicolas Bott, Abraham Brody, Savannah Forester, Cameron Gettel, Elizabeth Goldberg, Allyson Greenberg, Nada Hammouda, Nicole S Hastings, Teresita Hogan, William Hung, Jay Kayser, Elizabeth Linton, Aaron Malsch, Carmen Morano Don Melady, Nancy Morrow-Howell, Lori Nerbonne, Sylvie Nyamu, Ugochi Ohuabunwa, Timothy Platts-Mills, Luna Ragsdale, Thom Ringer, Anthony Rosen, Rachel Skains, Stephanie Skees, Kimberly Souffront, Laura Stabler, Joseph Suyama, Samuel Vargas, E Camille Vaughan, Corrine Voils, Heather Allore, Amy Aloysi, Michael Belleville, M Fernanda Bellolio, Jennie Chin-Hansen, Morgan Daven, Nida Degesys, Michael Ellenbogen, Marcus Escobedo, Jason Falvey, Thomas Gill, James Hardy, Amy JH Kind, Caitlin Malicki, Michael Malone, Richard Marottoli, Michelle Moccia, Nancy Morrow Howell, Brenda Oiyemhonlan, Kristin Rising, Mary Sano, Conor Sullivan, Joe Suyama, Jeremy Swartzberg, Vaishal Tolia, Allan Vann, Sandra Weintraub, and Susan Zieman

Subjects
Medicine
Abstract

Introduction Increasingly, older adults are turning to emergency departments (EDs) to address healthcare needs. To achieve these research demands, infrastructure is needed to both generate evidence of intervention impact and advance the development of implementation science, pragmatic trials evaluation and dissemination of findings from studies addressing the emergency care needs of older adults. The Geriatric Emergency Care Applied Research Network (https://gearnetwork.org) has been created in response to these scientific needs—to build a transdisciplinary infrastructure to support the research that will optimise emergency care for older adults and persons living with dementia.Methods and analysis In this paper, we describe our approach to developing the GEAR Network infrastructure, the scoping reviews to identify research and clinical gaps and its use of consensus-driven research priorities with a transdisciplinary taskforce of stakeholders that includes patients and care partners. We describe how priority topic areas are ascertained, the process of conducting scoping reviews with integrated academic librarians performing standardised searches and providing quality control on reviews, input and support from the taskforce and conducting a large-scale consensus workshop to prioritise future research topics. The GEAR Network approach provides a framework and systematic approach to develop a research agenda and support research in geriatric emergency care.Ethics and dissemination This is a systematic review of previously conducted research; accordingly, it does not constitute human subjects research needing ethics review. These reviews will be prepared as manuscripts and submitted for publication to peer-reviewed journals, and the results will be presented at conferences.Open Science Framework registered DOI: 10.17605/OSF.IO/6QRYX, 10.17605/OSF.IO/AKVZ8, 10.17605/OSF.IO/EPVR5, 10.17605/OSF.IO/VXPRS.

Published
2022
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2. Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement

Author

Cameron J. Gettel, Corrine I. Voils, Alycia A. Bristol, Lynne D. Richardson, Teresita M. Hogan, Abraham A. Brody, Micaela N. Gladney, Joe Suyama, Luna C. Ragsdale, Christine L. Binkley, Carmen L. Morano, Justine Seidenfeld, Nada Hammouda, Kelly J. Ko, Ula Hwang, Susan N. Hastings, M. Fernanda Bellolio, Kevin Biese, Christine Binkley, Nicholas Bott, Abraham Brody, Christopher Carpenter, Sunday Clark, M. Scott Dresden, Savannah Forrester, Lowell Gerson, Cameron Gettel, Elizabeth Goldberg, Allyson Greenberg, Jin Han, S. Nicole Hastings, Tess Hogan, William Hung, Jay Kayser, Maura Kennedy, Kelly Ko, Adriane Lesser, Elizabeth Linton, Shan Liu, Aaron Malsch, Daniel Matlock, Frances McFarland, Don Melady, Carmen Morano, Nancy Morrow‐Howell, Denise Nassisi, Lori Nerbonne, Sylvie Nyamu, Ugochi Ohuabunwa, Timothy Platts‐Mills, Luna Ragsdale, Lynne Richardson, Thom Ringer, Anthony Rosen, Mark Rosenberg, Manish Shah, Rachel Skains, Stephanie Skees, Kimberly Souffront, Laura Stabler, Connor Sullivan, Samuel Vargas, E Camille Vaughan, Corrine Voils, Daniel Wei, and Nancy Wexler

Subjects
Protocol (science), Patient Transfer, Emergency Medical Services, business.industry, digestive, oral, and skin physiology, Psychological intervention, General Medicine, Emergency department, Transitional Care, Patient Discharge, Article, Nursing, Data extraction, Intervention (counseling), Health care, Social needs, Emergency Medicine, Medicine, Humans, Applied research, business, Emergency Service, Hospital, Aged
Abstract

OBJECTIVES: Individual-level social needs have been shown to substantially impact emergency department (ED) care transitions of older adults. The Geriatric Emergency care Applied Research (GEAR) Network aimed to identify care transition interventions, particularly addressing social needs, and prioritize future research questions. METHODS: GEAR engaged 49 interdisciplinary stakeholders, derived clinical questions, and conducted searches of electronic databases to identify ED discharge care transition interventions in older adult populations. Informed by the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) framework, data extraction and synthesis of included studies included the degree that intervention components addressed social needs and their association with patient outcomes. GEAR convened a consensus conference to identify topics of highest priority for future care transitions research. RESULTS: Our search identified 248 unique articles addressing care transition interventions in older adult populations. Of these, 17 individual care transition intervention studies were included in the current literature synthesis. Overall, common care transition interventions included coordination efforts, comprehensive geriatric assessments, discharge planning, and telephone or in-person follow-up. Fourteen of the 17 care transition intervention studies in older adults specifically addressed at least one social need within the PRAPARE framework, most commonly related to access to food, medicine, or health care. No care transition intervention addressing social needs in older adult populations consistently reduced subsequent health care utilization or other patient-centered outcomes. GEAR stakeholders identified that determining optimal outcome measures for ED–home transition interventions was the highest priority area for future care transitions research. CONCLUSIONS: ED care transition intervention studies in older adults frequently address at least one social need component and exhibit variation in the degree of success on a wide array of health care utilization outcomes.

Published
2021

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