PROJECT ABSTRACT:
Research infrastructure in geriatric emergency care is needed to develop and test best practices in the
ED setting that address the medical, health, and psychosocial needs of older patients. Despite evolution of
interdisciplinary geriatric emergency department (GED) guidelines and the rapid growth and spread of self-
declared GEDs, there is limited evidence of what better quality geriatric emergency care consists of and even
less is known about the impact such care may have on patient outcomes. Thus, there is an imperative to
advance interdisciplinary geriatric emergency medicine research. This proposal will leverage preliminary work
from an early learning collaborative of 9 hospitals and health systems implementing geriatric emergency
medicine initiatives and a developing platform clinical data registry to create an interdisciplinary research
infrastructure.
The goal of this proposal is to launch the Geriatric Emergency care Applied Research (GEAR)
Network and facilitate the framing and building of a research infrastructure supporting interdisciplinary
aging studies focused on geriatric emergency medicine. Specifically, this network will: 1. Establish
research priorities and standardized data approaches and measures for common geriatric emergency care
syndromes, 2. Build a validated metrics data bank to support opportunities to conduct geriatric emergency care
research, and 3. Facilitate future multicenter proposals and applications for pragmatic trials, dissemination and
implementation studies, and other interdisciplinary projects that will further the advancement of best practices
in geriatric emergency care.
During the first framing phase (2-year R21) an interdisciplinary research task force will be convened of
geriatricians, emergency physicians, nurses, social workers, representatives of the collaborative, data
informatics experts, methodologists, pragmatic clinical trials experts, and dissemination and implementation
scientists. Following a structured research-to-practice consensus building format, this task force will propose
priorities, research approaches, and standardized measures for common geriatric syndromes and conditions
encountered in the ED. Four cores (with identified leads) in research, measurement, data and informatics and
dissemination and implementation will support the 3-year R33 phase. During the second building phase, a data
bank will be created from measures proposed by the task force. A multicenter evaluation will standardize,
validate and test these measures for feasibility of implementation. In the latter phase of the R33, there will be
an open call for 1-year pilot proposals. Pilot funding will preferentially support nascent investigators in geriatric
emergency medicine that propose interdisciplinary collaborations and use data driven approaches from the
GEAR infrastructure. The generation of preliminary data from these studies will further develop and build
future opportunities for multicenter, interdisciplinary aging study grant proposals.
