Geriatric Emergency Medicine

Dr. Don Melady

IMPROVING THE CARE OF OLDER PEOPLE THROUGH THE GERIATRIC ED COLLABORATIVE

Dr. Melady has also been working with the Geriatric ED Collaborative. This grew out of an invitation (from Dr. Chris Carpenter) to join the team of four American colleagues that had been involved with drafting the Geriatric ED Guidelines and subsequently involved in developing a strategy for disseminating and implementing them. The collaborative started as two pilot projects in Milwaukee and Pittsburgh (2014-15), to work with hospital front-line staff through to CEOs, in changes that allowed for better care of older people. The project was subsequently championed by the American Geriatric Society as a model for change and received a USD $1.3 million grant from the John A. Hartford Foundation and a matching grant from the West Health Foundation to scale it up to nine health care systems. The goals are to build a learning collaborative for further spread and to develop a research network to assess outcomes. In the past year, the group has developed a major project with the University of California at San Diego and ongoing activities at  Milwaukee, Pittsburgh, Mount Sinai New York and Northwestern University in Chicago.

CANADA’S FIRST GERIATRIC EMERGENCY MEDICINE FELLOWSHIP

2016 has been quite the year for Dr. Don Melady, our Geriatric Lead at SREMI. Dr. Melady has successfully developed Canada’s first geriatric emergency medicine (GEM) fellowship. This is one of very few post-licensure fellowships available to emergency medicine trained specialists. It was designed in cooperation with PGME at the University of Toronto and subsequently approved through a rigorous process by the Society of Academic Emergency Medicine.

We were able to attract an excellent fellow, Dr. Audrey-Anne Brousseau from Laval University, who divides her time between clinical shifts in the ED (functioning as a staff); advanced training in geriatric medicine, psychiatry, palliative medicine, trauma; research (focusing on frailty in the emergency department); and a diploma in adult education.

ACUTE CARE OF THE ELDERLY COLLABORATIVE

Dr. Melady is also involved in a parallel project, the Acute Care of the Elderly Collaborative, funded by the Canadian Foundation for Healthcare Improvement. This project uses Mount Sinai’s reputation as a leader in senior-friendly models of care to develop a collaborative of 18 hospitals across the country. Dr. Melady co-chairs the EM section and facilitates regular webinars and coaching sessions (including a two-day on-site conference which he organizes) to support ED teams to improve patient care.

At the International Conference on Emergency Medicine in Cape Town in April 2016, Dr. Melady was responsible for planning the geriatric content of the conference, bringing together researchers and educators from nine countries. Don is also the Chair of the Geriatric EM Interest Group within the International Federation of EM, and co-Chair of the CAEP Geriatric EM Committee. Dr. Melady shared the planning and delivery of a four-day Integrated Emergency Care of the Older Person Symposium in Australia in October, 2016.

SUPPORTING SENIOR-FRIENDLY EDs ACROSS CANADA

The Senior-Friendly ED Course, a development out of the Geriatric-ED Bootcamp, has now been presented in Toronto (15 hospitals; 3 provinces, 4 states), Winnipeg (15 hospitals; 4 provinces), Melbourne, Australia (20 hospitals; 5 countries), and will be presented in Vancouver in January 2017. Dr. Melady received an innovation grant to develop www.geriatric-ED.com, which will be a resource to ED and hospital managers across Canada in implementing senior-friendly ED change. The site is currently under development with an expected launch in March 2017.

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