No abstract

Optimizing heath care services for seniors in emergency departments (ED) is a core component of the "Senior Friendly Hospital Approach" being implemented in Quebec. We measured the availability of geriatric expertise in Quebec EDs and its relationship with ED characteristics such as university affiliation, number of stretchers, and geographical location.We surveyed (2013)(2014) head nurses and head physicians at 116 adult, non-psychiatric Quebec EDs. We defined high level of availability in the three following components of geriatric expertise: 1) geriatric care coordinatioN = a designated clinician coordinating the care of older adults available every day; 2) multidisciplinarity = 4 or 5 different nonmedical professionals, i.e., specialized nurse, social worker, occupational therapist, physiotherapist, and pharmacist, available almost always/often (nursereported); and 3) geriatric consultation = a specialist or a general practitioner specialized in geriatrics available almost always/often (physician-reported). We performed descriptive analyses and Fisher's exact test.Among participating EDs (N = 83), 73 (88%) nurses and 67 (81%) physicians participated in the survey. 18% of EDs had high level of geriatric care coordination, 41% provided high level of multidisciplinarity, and 33% received high level of geriatric consultation. We found that EDs that had greater number of stretchers were more likely to have high level of geriatric care coordination (p < .05) and consultation (p < .001). EDs in metropolitan areas were also more likely to receive high level of geriatric consultation (p < .01). High level of multidisciplinarity was not associated with any ED characteristics.2/5 of Quebec EDs provide high level of multidisciplinarity varying in their characteristics, whereas smaller and non-metropolitan EDs lack geriatric care coordination and consultation.There is a need for reorganisation and finding innovative ways to use existing human resources in Quebec EDs. Background: Use of potentially inappropriate medication (PIMs) in the hospitalized elderly can lead to adverse drug events, and contribute to geriatric syndromes. PIMs are frequently prescribed to elderly hospitalized patients, indicating the need to develop strategies to reduce their use. A Pharmacist-Physician Intervention Model Using a Computerized Alert System to Reduce High-Risk Medication Use in Elderly Inpatients Objectives:To assess 1) the applicability of a pharmacistphysician intervention model to reduce the use of highrisk medications and 2) the clinical relevance of the alerts generated by a computerized alert system (CAS). Methods:The study was conducted in patients aged 65 or older admitted to a teaching hospital between April and June 2014. In the intervention model, the pharmacist determined the clinical relevance of the CAS alerts, analyzed the patient's pharmacotherapy, and elaborated a geriatric pharmacotherapeutic plan to be discussed with the treating physician. The alerts were based on the Beers criteria. The main outcome was the change...