A structure and process evaluation of the Geriatric Emergency Department Intervention model.

BACKGROUND:The positive effect of the Geriatric Emergency Department Intervention (GEDI) model, on the outcomes of frail older adults, is established. This study aimed to describe and evaluate the structures and processes required for the effective delivery of the GEDI model to assist in its potential translation into emergency departments in Australia and overseas. METHODS:This was a descriptive qualitative study. Twenty-four semi-structured interviews were conducted with emergency department staff and GEDI doctors and nurses from a regional hospital in Queensland, Australia. An a priori framework guided interview questions and analysis. RESULTS:Structures required for successful model deployment included having an emergency department physician champion and nurses with gerontology experience, adequate funding, and geriatric specific resources. Processes identified as fundamental to the GEDI model included having a targeted approach to assessment, a patient-centred approach to care, and staff with inter-facility, intra-facility and inter-personal communication skills. CONCLUSIONS:The GEDI model addresses the specific care needs of our aging population. For optimal performance of the model, key structures and processes require identification and acknowledgement. Research involving qualitative methodology is vital for successful translation and integration of emergency department models of care.