18 Chapter 1 Aims of the thesis The aims of the thesis are as follows: 1. To identify risk factors for a prolonged length of stay in the ED for older adults. 2. To assess the effectiveness of interventions in reducing ED crowding with older adults (systematic review). 3. To assess emergency physicians’ self-perceived needs and their facilities regarding geriatric emergency care education (nationwide survey). 4. To evaluate the effect of a geriatric education program on emergency physicians’ geriatric knowledge, attitudes and medical practice when treating older adults (pre-post study). 5. To determine whether the teach-back method can reduce ED revisits and increase patient knowledge retention of discharge instructions, self-management at home and satisfaction with the provision of discharge instructions (prepost study). Outline of the thesis To achieve the abovementioned research goals, we conducted 5 studies, which we briefly describe below. In chapter 2, we describe our retrospective cohort study. We determined the length of stay of older adults in our ED and identified risk factors for prolonged length of stay of older adults in the ED. We analysed the medical records of 2000 patients ≥70 years old presenting at our ED and identified the associations between length of stay and patient characteristics, as well as organizational and clinical factors. In chapter 3, we present a systematic review to assess the effectiveness of interventions on reducing ED crowding by older adults and to identify core characteristics shared by successful interventions. Six major biomedical databases were searched for (quasi)experimental studies published between January 1990 and March 2017. In chapter 4, we assess emergencyphysicians’ self-perceivedneeds regarding geriatric emergency medicine education by an online survey. The survey was administered by e-mail to all 503 emergency physicians in the Netherlands. Another survey was e-mailed to all 83 emergency department managers in the Netherlands to assess their role in providing support for geriatric emergency medicine education for emergency physicians. In chapter 5, we evaluate the effect of a self-developed and implemented geriatric education program on emergency physicians’ geriatric knowledge,
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