#226 Age-friendly healthcare in the mid-west: the geriatric emergency medicine unit

<h3>Introduction</h3> There is unequivocal evidence that the emergency department (ED) is a challenging environment to deliver holistic care to older adults living with frailty; prolonged exposure predisposes older adults to a range of adverse outcomes. The Geriatric Emergency Medicine (GEM) Unit opened in University Hospital Limerick (UHL) in 2023 with the overall aim of improving the experience and outcomes of older adults aged ≥75 years that attend the ED. The GEM Unit is operational 24/7 and is staffed by an interdisciplinary team comprising Emergency Medicine, Nursing, and Health and Social Care Professions (HSCP). This service evaluation aims to profile 6-month disposition and process outcomes. <h3>Methodology</h3> Our initiative was underpinned by a quality improvement methodology comprising tests of change. Descriptive statistics were used to profile the baseline and demographic characteristics and to summarize data related to process outcomes. <h3>Results</h3> A total of 845 older adults were assessed by the HSCP team in Q1 and Q2 2024; 58.2% (N=492) were discharged home following their index attendance with 41.8% (N=353) requiring admission. The overall GEM Unit conversion rate of 41.8% is 11.7% lower than the composite UHL 75+ conversion rate of 53.5% (HSE Planning and Performance Unit). Based on empirical evidence, this equates to cost savings of €606,672 year to date (YTD) and predicted annual savings of €1,213,344 based on a 5-day HSCP service (https://doi.org/10.1371/journal.pone.0298162). The 30-day unscheduled ED revisit continues to trend down year-on-year from 18.8% in 2019 to 13% YTD 2024. <h3>Conclusion</h3> The interdisciplinary team espouse an integrated approach to care at the primary-secondary care interface and focus on a left-shift in reform and activity. This is achieved by exploring alternatives to hospital admission with older adults and active engagement with colleagues across the HSE Mid-West health region to ensure older adults are supported to return home.