The Geriatric Emergency Care Applied Research (GEAR) network approach: a protocol to advance stakeholder consensus and research priorities in geriatrics and dementia care in the emergency department

Abstract

IntroductionIncreasingly, older adults are turning to emergency departments (EDs) to address healthcare needs. To achieve these research demands, infrastructure is needed to both generate evidence of intervention impact and advance the development of implementation science, pragmatic trials evaluation and dissemination of findings from studies addressing the emergency care needs of older adults. The Geriatric Emergency Care Applied Research Network (https://gearnetwork.org) has been created in response to these scientific needs—to build a transdisciplinary infrastructure to support the research that will optimise emergency care for older adults and persons living with dementia.Methods and analysisIn this paper, we describe our approach to developing the GEAR Network infrastructure, the scoping reviews to identify research and clinical gaps and its use of consensus-driven research priorities with a transdisciplinary taskforce of stakeholders that includes patients and care partners. We describe how priority topic areas are ascertained, the process of conducting scoping reviews with integrated academic librarians performing standardised searches and providing quality control on reviews, input and support from the taskforce and conducting a large-scale consensus workshop to prioritise future research topics. The GEAR Network approach provides a framework and systematic approach to develop a research agenda and support research in geriatric emergency care.Ethics and disseminationThis is a systematic review of previously conducted research; accordingly, it does not constitute human subjects research needing ethics review. These reviews will be prepared as manuscripts and submitted for publication to peer-reviewed journals, and the results will be presented at conferences.Open Science Framework registered DOI: 10.17605/OSF.IO/6QRYX, 10.17605/OSF.IO/AKVZ8, 10.17605/OSF.IO/EPVR5, 10.17605/OSF.IO/VXPRS.

Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review

“…The workgroup, over the course of 6 months, convened videoconference meetings to discuss the scoping review aims, propose the research questions, review the search criteria, and examine the scoping review results, and abstraction of final papers. 7 The Detection workgroup conducted a scoping review adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guidelines 8 used by all 4 workgroups. The Detection workgroup developed key priority questions that were voted on by the entire GEAR 2.0 task force.…”

“…The majority of manuscripts included people aged !65 years. The number of studies and age criteria were as follows: !18 years (1), !45 years (1), !55 years (1), !60 years (1), !65 years (24), !70 years (4), and !75 years (7).…”

Optimal Emergency Department Care Practices for Persons Living With Dementia: A Scoping Review

“…The workgroup developed 5 key questions that were brought forward for consideration at the GEAR 2.0-ADC Consensus Conference as reported elsewhere. 20 The results of this scoping review and the research objectives were presented at the 2-day virtual consensus conference held on September 10-11, 2021. GEAR 2.0 ADC members who were unable to attend the consensus conference live voted through a REDCap Survey link.…”

Emergency department care transition barriers: a qualitative study of care partners of older adults with cognitive impairment

“…ED discharge care transitions have been prioritized within the 2014 Geriatric ED Guidelines 13 and the 2018 launch of the American College of Emergency Physicians geriatric ED accreditation process. 14 Recent ED-centric initiatives, as part of the Geriatric Emergency care Applied Research 2.0 Network -Advancing Dementia Care, 15 identified the need for the development of patient-and care partner-reported outcome measures that capture what matters most to stakeholders during ED care transitions. 6,16 As a first step towards developing a novel care partner-reported outcome measure, we sought to assess the barriers experienced by care partners of PLWCI during ED discharge care transitions.…”