2/ First, we screened 9,359 older adults in the ED for memory/thinking problems. ~5% of patients and 33% of care partners flagged possible CI – 650 in total were eligible for referral. Yet only 100 were actually referred. That’s a big drop – we’ll get to potential reasons for this in a bit.

🧵 1/ Check out our team’s new study in @alzdemjournals.bsky.social on ED-based cognitive impairment (CI) screening and referral. What we found highlights both promise and pain points in real-world detection and follow-up for CI and dementia in the acute care setting.

bit.ly/4cMO8M0

6/ This work is directly responsive to efforts from the multidisciplinary Geriatric Emergency care Applied Research (GEAR) network:

gearnetwork.org
pubmed.ncbi.nlm.nih.gov/34328674/

3/ ✅ The final 18-item PROM-OTED tool measures critical aspects like understanding discharge instructions, medication management, follow-up care, and quality of life. It’s validated with excellent reliability and a robust factor structure.

1/ 🚨 ED care transitions are critical for older adults, but no standardized tools have been available to measure patient-reported outcomes. Here we share the development and validation of the PROM-OTED tool to address this gap.

Access in @aem-journal.bsky.social: pubmed.ncbi.nlm.nih.gov/40155783/

1/ Aging patients often visit the ED with undiagnosed cognitive impairment. Spotting cognitive issues here can guide critical care decisions, yet feasible tools remain underused. 🧵

🔎 Check out our latest published work here led by @jamesgalske.bsky.social:

bit.ly/4jojfQM

6/ Anti-amyloid therapies are gaining approval and access, meaning we will see more Alzheimer’s patients on these treatments in the ED. Maintaining a high index of suspicion is important when caring for patients with dementia in the ED.

1/ 🧵 Anti-amyloid therapies are changing the landscape of Alzheimer’s care, and emergency physicians will increasingly encounter their complications. A must-read review by @meganarech.bsky.social et al. in @annalsofem.bsky.social breaks it down:
bit.ly/40JgC3F

📊 Key Findings
13.8% avg annual attrition rate (2014-2021).
Women had higher attrition (14.7%) than men (11.8%).
Rural PAs/NPs faced higher attrition (15.1%) than urban counterparts (13.1%).
The EM workforce is growing but not without challenges. (3/5)

🔍 The Issue

Clinically, I often work with new PAs/NPs who show promise in EM, only to see them leave for other settings. PAs/NPs are critical in emergency care, especially in rural & underserved areas. This 'churn' affects not just the workforce but also the care we provide to patients. (2/5)

🌟 Our new study published in @annalsofem.bsky.social 🌟

TL;DR - Emergency PAs/NPs face a 13.8% annual attrition rate, with women and rural clinicians most affected—highlighting workforce challenges.

50 days free access:
authors.elsevier.com/a/1kSLzib7EM...

🧵 (1/5)