111 Geriatric education program for emergency physicians CHAPTER 5 Interviewees expressed that the program did not change their view on older adults other than their improved ability to discern frail older adults from regular older adults. Effects on EPs’ medical practice EPs gave statistically significant more attention to the patient’s social circumstances after the program (32% versus 54% p=0.04; table 4). Overall, more diagnostics were performed for older patients after the program, and EPs examined more often the patient’s sensory capacity and ability to perform activities of daily living (ADL), but statistical significance for found differences lacked. No statistical significant differences were found for the consultation of a geriatrician and other medical specialties, and EPs’ problem definition of CGA before and after the program. According to interviewed EPs, the program improved the collaboration between the EP and the geriatrician. Interviewees described that they contact the geriatrician at a much earlier stage nowadays, because they are better able to formulate their request to the consultant geriatrician. One interviewee also expressed, that the program helped her to see the geriatric consult as a mean for determining appropriate patient care based on the input of the geriatrician, rather than as a mean for handing over the patient to the geriatrician. This made her less hesitant to call the geriatrician. EP 2: I think you are more aware of being in this together. That you do not ask someone to take part in the consultation because you very much want to hand over the complete care for the patient to him or her, but because you want to discuss things: “How are we going to deal with this together? What is the best thing to do?” (...) And because of that you are also more inclined to phone [the geriatrician]. Moreover, interviewees expressed that they seek input from the geriatrician more often, because the program made them more aware of the added value of the geriatrician when diagnosing and treating older patients at the ED. EP 6: I tend to call the geriatrician much more now to discuss things: “We have this female older patient here with a fractured hip, but I am not just asking you for a preoperative consultation. The patient is frail because of various things. And I do not think that she should be operated on.” (...) Whereas previously (...) I would formulate a request as: “The orthopedic surgeon would like to operate, and I would like you to come and check whether the patient is in a fit state for undergoing surgery.”
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