Initial steps in addressing the challenges of elder mistreatment evaluation: Protocol for evaluating the Vulnerable Elder Protection Team.

Introduction: Although many programmes have been developed to address elder mistreatment, high-quality, rigorous evaluations to assess their impact are lacking. This is partly due to challenges in conducting programme evaluation for such a complex phenomenon. We describe here the development of a protocol to mitigate these challenges and rigorously evaluate a first-of-its-kind emergency department/hospital-based elder mistreatment intervention, the Vulnerable Elder Protection Team (VEPT).

Vulnerable Elder Protection Team: Initial experience of an emergency department-based interdisciplinary elder abuse program.

Background: An emergency department (ED) visit provides a unique opportunity to identify elder abuse and initiate intervention, but emergency providers rarely do. To address this, we developed the Vulnerable Elder Protection Team (VEPT), an ED-based interdisciplinary consultation service. We describe our initial experience in the first two years after the program launch.

Virtual Clinical Shadowing for Pre-Clinical Medical Students in an Emergency Medicine-Based Leadership Course.

The COVID-19 pandemic limited pre-clinical medical students from participating in traditional clinical in-person shadowing. Rather than eliminating clinical shadowing from an established leadership course, we describe the experience of six pre-clinical medical students shadowing physician preceptors remotely through virtual platforms. Six pre-clinical medical students enrolled in 2020's Weill Cornell Medicine's Healthcare Leadership and Management Scholars Program were prepared with training materials for on-camera patient care.

Geriatric Burn Injuries Presenting to the Emergency Department of a Major Burn Center: Clinical Characteristics and Outcomes.

Background: Burn injuries in geriatric patients are common and may have significant associated morbidity and mortality. Most research has focused on the care of hospitalized patients after admission to burn units. Little is known about the clinical characteristics of geriatric burn victims who present to the emergency department (ED) and their ED assessment and management.

Curricular response to COVID-19: real-time interactive telehealth experience (RITE) program.

. The COVID-19 pandemic placed an unprecedented strain on academic healthcare systems necessitating a pause in medical student teaching in clinical care settings, including at Weill Cornell Medicine (WCM). WCM had a preexisting telemedicine curriculum, but limited opportunities for students to apply knowledge and skills related to direct virtual patient care.

Advanced Communication and Examination Skills in Telemedicine: A Structured Simulation-Based Course for Medical Students.

Introduction: Telemedicine has become part of mainstream medical practice. High quality virtual care is a skill that will be required of many physicians. Skills required for effective evaluation and communication during a video encounter differ from skills required at bedside, yet few rubrics for educational content and student performance evaluation in telemedicine training have been developed.

Geriatric Emergency Medicine Fellowships: Current State of Specialized Training for Emergency Physicians in Optimizing Care for Older Adults.

Improving emergency department (ED) care for older adults is a critical issue in emergency medicine. Institutions throughout the United States and Canada have recognized the growing need for a workforce of emergency physician (EP) leaders focused on clinical innovation, education, and research and have developed specialized fellowship training in geriatric emergency medicine (GEM). We describe here the overview, structure, and curricula of these fellowships as well as successes and challenges they have encountered.

Developing the Emergency Department Elder Mistreatment Assessment Tool for Social Workers Using a Modified Delphi Technique.

Elder mistreatment is common and has serious consequences. The emergency department (ED) may provide a unique opportunity to detect this mistreatment, with social workers often asked to take the lead in assessment and intervention. Despite this, social workers may feel ill-equipped to conduct assessments for potential mistreatment, due in part to a lack of education and training.

A Novel Emergency Department-Based Telemedicine Program: How Do Older Patients Fare?

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Emergency department provider perspectives on elder abuse and development of a novel ED-based multidisciplinary intervention team.

Background: An ED visit provides a unique opportunity to identify elder abuse, which is common and has serious medical consequences. Despite this, emergency providers rarely recognise or report it. We have begun the design of an ED-based multidisciplinary consultation service to improve identification and provide comprehensive medical and forensic assessment and treatment for potential victims.

Identifying and Initiating Intervention for Elder Abuse and Neglect in the Emergency Department.

Elder abuse and neglect are common and may have serious medical and social consequences but are infrequently identified. An emergency department (ED) visit represents a unique but usually missed opportunity to identify potential abuse and initiate intervention. ED assessment should include observation of patient-caregiver interaction, comprehensive medical history, and head-to-toe physical examination.

Improving Quality of Care in Hospitals for Victims of Elder Mistreatment: Development of the Vulnerable Elder Protection Team.

Problem Definition: Hospitals have an opportunity to improve the quality of care provided to a particularly vulnerable population: victims of elder mistreatment. Despite this, no programs to prevent or stop elder abuse in the acute care hospital have been reported. An innovative, multidisciplinary emergency department (ED)-based intervention for elder abuse victims, the Vulnerable Elder Protection Team (VEPT), was developed at NewYork-Presbyterian / Weill Cornell Medical Center (New York City).

Implementation of Scribes in an Academic Emergency Department: The Resident Perspective.

Background: Medical scribes have been shown to improve emergency department (ED) throughput, physician productivity metrics, and patient satisfaction by fulfilling primary documentation and nonclinical functions. Little research has been done to date to study the effect of implementing a scribe program in a residency setting.

Objective: Our goal was to investigate emergency medicine residents' perception of their educational experience, including interactions with faculty, before and after the implementation of an ED scribe program.

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

Background: Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities.

Objective: To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment.

Assessing Coagulation by Rotational Thromboelastometry (ROTEM) in Rivaroxaban-Anticoagulated Blood Using Hemostatic Agents.

Unlabelled: Introduction The use of direct oral anticoagulants (DOACs) such as rivaroxaban (Xarelto) is increasingly common. However, therapies for reversing anticoagulation in the event of hemorrhage are limited. This study investigates the ability of hemostatic agents to improve the coagulation of rivaroxaban-anticoagulated blood, as measured by rotational thromboelastometry (ROTEM).

Geriatric assault victims treated at U.S. trauma centers: Five-year analysis of the national trauma data bank.

Introduction: While geriatric trauma patients have begun to receive increased attention, little research has investigated assault-related injuries among older adults. Our goal was to describe characteristics, treatment, and outcomes of geriatric assault victims and compare them both to geriatric victims of accidental injury and younger assault victims.

Patients And Methods: We conducted a retrospective analysis of the 2008-2012 National Trauma Data Bank.

Photographing Injuries in the Acute Care Setting: Development and Evaluation of a Standardized Protocol for Research, Forensics, and Clinical Practice.

Background: Photographing injuries in the acute setting allows for improved documentation as well as assessment by clinicians and others who have not personally examined a patient. This tool is important, particularly for telemedicine, tracking of wound healing, the evaluation of potential abuse, and injury research. Despite this, protocols to ensure standardization of photography in clinical practice, forensics, or research have not been published.

Interrater reliability of emergency physician-performed ultrasonography for diagnosing femoral, popliteal, and great saphenous vein thromboses compared to the criterion standard study by radiology.

Purpose: To assess the interrater reliability and test characteristics of lower limb sonographic examination for the diagnosis of deep venous and proximal great saphenous vein thrombosis when performed by Emergency Physicians (EPs) as compared to that by the Department of Radiology (Radiology). The secondary objective was to assess the effects of patient body mass index and EP satisfaction with bedside ultrasound on sensitivity and specificity.

Methods: A prospective study was conducted for patients with clinical suspicion for lower extremity thrombus.

A Novel Clinical Protocol for Placement and Management of Indwelling Urinary Catheters in Older Adults in the Emergency Department.

Objectives: Indwelling urinary catheters (IUCs) are placed frequently in older adults (age ≥ 65 years) in the emergency department (ED) and carry significant risks. The authors developed, implemented, and assessed a novel clinical protocol to assist ED providers with appropriate indications for placement, reassessment, and removal of IUCs in elders in the ED.

Methods: A comprehensive, evidence-based clinical protocol was built from an extensive literature review and ED provider focus groups.

Emergency Department Placement and Management of Indwelling Urinary Catheters in Older Adults: Knowledge, Attitudes, and Practice.

Unlabelled: Indwelling urinary catheters (IUCs) are placed frequently in older adults in the emergency department (ED). Though often a critical intervention, IUCs carry significant risks. Our objective was to examine current knowledge, attitudes, and practice of emergency nurses and other providers regarding IUC placement and management in older adults.

Provider perspectives on the use of indwelling urinary catheters in older adults in emergency department settings: developing a novel clinical protocol.

Background: Indwelling urinary catheters (IUCs) are commonly placed in older adult (aged ≥ 65 years) patients in emergency department (ED) settings, often for inappropriate indications. The aim of our qualitative study was to explore ED provider knowledge, attitudes, and practice patterns surrounding use of IUCs in older adult patients in the ED setting, to better guide development of a clinical protocol.

Methods: We conducted 4 focus groups with 38 participants at a large academic medical center.

Improving front-end flow in an urban academic medical center emergency department: the emergency department discharge facilitator team.

Length of stay (LOS) is an important determinant of patient satisfaction and overall emergency department (ED) operational efficiency. In an effort to reduce length of stay for low-acuity "treated and released" patients, our department created a discharge facilitator team (DFT) composed of an attending physician, physician assistant, and registered nurse. The DFT identified patients who could be rapidly treated and released in the low-acuity treatment Adult Urgent Care Center (AUCC) and provided them rapid treatment and discharge.