Here are the top 3 most practice-changing and policy-relevant articles from the evidence base (2021–2025) for improving emergency care of older adults in the Australian and New Zealand context:
1. Marsden E et al. (2022). Translation of the Geriatric Emergency Department Intervention (GEDI) into other EDs: Outcomes for older adults. BMC Geriatrics, 22:290.
📌 Why it matters:
This is the definitive evaluation of scaling up a proven Australian geriatric ED model (GEDI) across different sites. It provides compelling real-world evidence that a nurse-led, physician-championed geriatric ED team improves outcomes for patients aged 70+, including:
- Increased safe discharges home
- Reduced ED length of stay
- Lower in-hospital costs
- No increase in mortality or readmission
📖 Takeaway: This article proves that geriatric ED models are adaptable, sustainable, and effective in routine practice across hospitals – not just in pilot settings.
🔗 Open Access – BMC Geriatrics
2. Churruca K et al. (2024). Strategies to improve care for older adults in the ED: A systematic review. BMC Health Services Research, 24:304.
📌 Why it matters:
This comprehensive systematic review synthesizes 76 studies (including Australian and NZ initiatives) covering:
- Multidisciplinary geriatric ED models
- Frailty screening tools
- Medication safety and deprescribing
- Discharge coordination
- Staff education and training
📖 Takeaway: Offers a bird’s-eye view of which ED strategies are most effective for older people, and which have limited or mixed evidence. A must-read for researchers, educators, and health service leaders designing ED reforms.
Notice how the author name isn’t Testa – the first author. One of the early errors that get’s corrected later.
🔗 Open Access – BMC Health Services Research
3. Hubbard RE et al. (2023). Frailty screening in the emergency department: A Delphi consensus study. Age and Ageing, 52(6):afad069.
📌 Why it matters:
This international Delphi consensus (with Australian representation) defines what an ideal frailty screening tool should look like for ED use, including:
- Should take <5 minutes
- Include function, mobility, cognition, medications, and support
- Performed within the first 4 hours of ED stay
- Must assess baseline functional status, not just current condition
📖 Takeaway: This article lays the foundational framework for implementing frailty screening in EDs – essential for early risk stratification and tailoring care for vulnerable older adults.
Life In The Slower Lane 
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