Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study

M. G. A. M. van der Velde; M. A. C. Jansen; F. Derkx-Verhagen; I. P. B. Tournoij; F. S. Jonkers; H. R. Haak; M. N. T. Kremers

doi:10.1007/s41999-025-01226-8

Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study

M. G. A. M. van der Velde^*, M. A. C. Jansen, F. Derkx-Verhagen, I. P. B. Tournoij, F. S. Jonkers, H. R. Haak, M. N. T. Kremers

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Aim: Management of older patients presenting to the Emergency Department (ED) with nonspecific complaints (NSC) is challenging. Therefore we implemented a structured care-pathway aiming to optimise diagnostics and treatment of this vulnerable population. Findings: NSC-patients showed increased comorbidities, polypharmacy and frailty. The implementation of the care-pathway showed non-significant trends towards improved diagnostic completeness, which might be associated with the reduced rate of 30-day readmissions. Patient reported outcomes measured in the intervention group, indicated a positive experience with the quality of care. Message: NSC-patients are a complex ED-population. The NSC-pathway showed trends towards improved diagnostic completeness and reduced 30-day readmission rates, but did not improve LOS-ED and LOS-H. Adaptation of the NSC-pathway could enhance effective and efficient care for this population.

Original language	English
Article number	e840
Number of pages	13
Journal	European Geriatric Medicine
DOIs	https://doi.org/10.1007/s41999-025-01226-8
Publication status	E-pub ahead of print - 7 May 2025

Keywords

Emergency medicine
Nonspecific complaints
Older adults
Care pathway
CLINICAL-OUTCOMES
HEALTH
UNDERTRIAGE
PATIENT
TRIAGE

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van der Velde, M. G. A. M., Jansen, M. A. C., Derkx-Verhagen, F., Tournoij, I. P. B., Jonkers, F. S., Haak, H. R., & Kremers, M. N. T. (2025). Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study. European Geriatric Medicine, Article e840. Advance online publication. https://doi.org/10.1007/s41999-025-01226-8

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title = "Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study",

abstract = "Aim: Management of older patients presenting to the Emergency Department (ED) with nonspecific complaints (NSC) is challenging. Therefore we implemented a structured care-pathway aiming to optimise diagnostics and treatment of this vulnerable population. Findings: NSC-patients showed increased comorbidities, polypharmacy and frailty. The implementation of the care-pathway showed non-significant trends towards improved diagnostic completeness, which might be associated with the reduced rate of 30-day readmissions. Patient reported outcomes measured in the intervention group, indicated a positive experience with the quality of care. Message: NSC-patients are a complex ED-population. The NSC-pathway showed trends towards improved diagnostic completeness and reduced 30-day readmission rates, but did not improve LOS-ED and LOS-H. Adaptation of the NSC-pathway could enhance effective and efficient care for this population.",

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doi = "10.1007/s41999-025-01226-8",

language = "English",

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TY - JOUR

T1 - Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department

T2 - a before-and-after study

AU - van der Velde, M. G. A. M.

AU - Jansen, M. A. C.

AU - Derkx-Verhagen, F.

AU - Tournoij, I. P. B.

AU - Jonkers, F. S.

AU - Haak, H. R.

AU - Kremers, M. N. T.

PY - 2025/5/7

Y1 - 2025/5/7

N2 - Aim: Management of older patients presenting to the Emergency Department (ED) with nonspecific complaints (NSC) is challenging. Therefore we implemented a structured care-pathway aiming to optimise diagnostics and treatment of this vulnerable population. Findings: NSC-patients showed increased comorbidities, polypharmacy and frailty. The implementation of the care-pathway showed non-significant trends towards improved diagnostic completeness, which might be associated with the reduced rate of 30-day readmissions. Patient reported outcomes measured in the intervention group, indicated a positive experience with the quality of care. Message: NSC-patients are a complex ED-population. The NSC-pathway showed trends towards improved diagnostic completeness and reduced 30-day readmission rates, but did not improve LOS-ED and LOS-H. Adaptation of the NSC-pathway could enhance effective and efficient care for this population.

AB - Aim: Management of older patients presenting to the Emergency Department (ED) with nonspecific complaints (NSC) is challenging. Therefore we implemented a structured care-pathway aiming to optimise diagnostics and treatment of this vulnerable population. Findings: NSC-patients showed increased comorbidities, polypharmacy and frailty. The implementation of the care-pathway showed non-significant trends towards improved diagnostic completeness, which might be associated with the reduced rate of 30-day readmissions. Patient reported outcomes measured in the intervention group, indicated a positive experience with the quality of care. Message: NSC-patients are a complex ED-population. The NSC-pathway showed trends towards improved diagnostic completeness and reduced 30-day readmission rates, but did not improve LOS-ED and LOS-H. Adaptation of the NSC-pathway could enhance effective and efficient care for this population.

KW - Emergency medicine

KW - Nonspecific complaints

KW - Older adults

KW - Care pathway

KW - CLINICAL-OUTCOMES

KW - HEALTH

KW - UNDERTRIAGE

KW - PATIENT

KW - TRIAGE

U2 - 10.1007/s41999-025-01226-8

DO - 10.1007/s41999-025-01226-8

M3 - Article

SN - 1878-7649

JO - European Geriatric Medicine

JF - European Geriatric Medicine

M1 - e840

ER -

Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study

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Keywords

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