title: Geriatric support in the emergency department: a national survey in Belgium.
abstract: Older people in the emergency department (ED) represent a growing population and increasing proportion of the workload in the ED. This study investigated the support for frail older people in the ED, by exploring the collaboration between the geriatric services (GS) and the EDs in Belgian hospitals.
  
  
  
  An electronic cross-sectional survey in all Belgian hospitals with an ED (n = 100) about care aspects, collaboration, education and infrastructure for older patients in the ED was collected. Descriptive analyses were performed at national level.
  
  
  
  Forty-nine of 100 surveys were completed by the GS. The heads of the ED returned only 12 incomplete questionnaires and these results are therefore not reported. Twenty-six of the 49 heads of GSs (53%) indicated that there was an agreement, mainly informal, between the geriatric and the emergency department concerning the management of older people on the ED. A geriatrician was available for specific problems, by phone or in person, in 96% of the EDs during daytime on weekdays. Almost all responding hospitals (96%) had an inpatient geriatric consultation team, of which 85% was available for specific problems at the ED, by phone or bedside during the daytime on weekdays. Twenty-nine heads of the GSs (59%) reported that older patients were screened at ED admission during the day to identify 'at risk' patients. The results of the screening were used in the context of further treatment (76%), to decide on hospital admission (27%), or to justify admission on a geriatric ward (55%). In the year preceding the survey, 25% of the responding hospitals had organised geriatric training for ED healthcare workers. Thirty-four heads of the GS (69%) felt that the infrastructure of the ED was insufficient to give high-quality care for older persons.
  
  
  
  Collaborations between EDs and GS are emerging in Belgium, but are currently rather limited and not yet sufficiently embedded in the ED care. Exploratory studies are necessary to identify how these collaborations can be improved.
authors.affiliation: Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium.|Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Devriendt
authors.affiliation: Division of Geriatric Medicine, Cliniques Universitaires St-Luc, av Hippocrate 10, 1200, Brussels, Belgium.|Institute of Health and Society, Université catholique de Louvain, clos Chapelle-aux-champs 30, 1200, Brussels, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: De Brauwer
authors.affiliation: Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium.
authors.forename: Lies
authors.initials: L
authors.lastname: Vandersaenen
authors.affiliation: Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium.|Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Heeren
authors.affiliation: Geriatric Medicine, University Hospitals of Leicester, Leicester, LE1 5WW, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Conroy
authors.affiliation: Division of Geriatric Medicine, Cliniques Universitaires St-Luc, av Hippocrate 10, 1200, Brussels, Belgium.|Institute of Health and Society, Université catholique de Louvain, clos Chapelle-aux-champs 30, 1200, Brussels, Belgium.
authors.forename: Benoit
authors.initials: B
authors.lastname: Boland
authors.affiliation: Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.|Department of Clinical and Experimental Medicine, Gerontology and Geriatrics, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Flamaing
authors.affiliation: Department of Emergency Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.|Department of Public Health and Primary Care, Emergency Medicine, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Sabbe
authors.affiliation: Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium. koen.milisen@med.kuleuven.be.|Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. koen.milisen@med.kuleuven.be.
authors.forename: Koen
authors.initials: K
authors.lastname: Milisen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration*; D006760:Hospitalization; D006801:Humans; D000070516:Intersectoral Collaboration; D008297:Male; D020380:Needs Assessment; D058996:Quality Improvement; D012944:Social Support
keywords: Emergency department; Geriatric patients; Geriatric support; Survey