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A recent qualitative study conducted by researchers at Ohio State’s CATALYST—the Center for the Advancement of Team Science, Analytics, and Systems Thinking—now shows that assistive devices, such as walking aids and hearing amplifiers, can significantly help older patients navigate an emergency department when made available.
Relying on interviews conducted in a geriatric emergency department (GED) with both patients and their care providers, the researchers were able to build a list of recurring themes. Findings are summarized in “Geriatric assistive devices improve older patient engagement and clinical care in an emergency department,” which was published in the August 2020 edition of the American Journal of Emergency Medicine.
“There was a move to add assistive devices to GEDs after national emergency medicine and geriatric societies released joint guidelines in 2014 outlining the already-proven value of devices in other settings,” says Naleef Fareed, PhD, an assistant professor in the Department of Biomedical Informatics at Ohio State and one of the authors of the study.
Dr. Fareed, who is also a core faculty member with CATALYST, adds “However, there was no existing evaluation of the impact on GED patient experiences. We wanted to confirm the availability, use and effectiveness of these devices and provide ideas for changes or improvements.”
Overall, all of the participants said they felt access to assistive devices in the GED was beneficial, and patients said they were offered the devices without needing to ask for them.
“This proactive approach is encouraging, because we found that patients typically don’t bring their devices from home,” Dr. Fareed says. “Being without them makes it more difficult for patients to perform tasks such as walking to the restroom (because of mobility issues) or responding correctly to questions (because of poor hearing).”
Care providers who took part in the interviews said they also found incorporating assistive devices allowed patients to be more engaged in their care.
“Older adults report more difficulty navigating the ED system, understanding how to call the nurse or provider, and being fearful during their visit,” Dr. Fareed explains. “GED equipment may assist with these difficulties in communication and care navigation, ultimately giving patients greater independence during their GED stay and improving the care team’s ability to assess a patient’s condition.
“Existing studies suggest that strong patient engagement can increase adherence to treatment recommendations and improve outcomes,” Fareed says. “For example, providers in our study noted that walkers and canes made it easier to understand the patient’s mobility, and hearing aids allowed the patient to respond directly to their questions, helping ascertain cognitive status. The impact of this improved assessment ability can be significant, as the decision to hospitalize a patient is often made based on the ED physician’s assessment of how the patient will be able to function at home with their new illness or injury.”
Going forward, Dr. Fareed says, there is a need to make such tools easier for patients to use.
“Providers in our study had only recently begun offering assistive devices as part of their care in a geriatric ED,” he says. “They recommended reminders to use the devices tied to their assessments and keeping devices in a central location as ways to increase their use.”
