Aims
To describe the implementation of a Geriatric Emergency Department Intervention (GEDI) service in a tertiary emergency department (ED) and report early service utilisation and admission outcomes.
Methods
A second iteration of our GEDI service in a tertiary ED commenced in November 2025. The model consists of a geriatrician embedded in ED during weekday, initially 2 hours shifts, 3 days per week, later scaled and adapted to 4 hour shifts, 5 days per week. Older patients were referred for GEDI review or screened for self referral based on clinician judgement rather than rigid eligibility criteria, reflecting the wide range of presentations where geriatric input may add value. This intentionally flexible approach prioritised frailty, cognitive impairment, functional decline, complex discharge needs, or diagnostic uncertainty. Service activity and admission outcomes for patients reviewed by GEDI were descriptively analysed.
Results
Following implementation, referrals to GEDI increased and time spent on screening decreased as integration with ED workflows improved. Among patients reviewed by GEDI, 54% avoided inpatient admission and 67% did not require acute inpatient admission. Due to the service evaluation design, the counterfactual proportion of admissions in the absence of GEDI review could not be determined.
Conclusions
This early experience suggests that an established GEDI model can be adapted to a local tertiary ED setting with limited initial resourcing. An intentionally flexible referral model supported early uptake and clinician engagement but limits causal inference regarding admission avoidance. Future evaluation will incorporate multidisciplinary expansion and the development of patient-centred and qualitative outcome measures.