ED physician role in the GEDI model
The ED physician’s role in a GEDI model is to provide medical leadership for the GEDI service. This role is multifaceted. The incumbent needs the respect of colleagues to influence the hospital and ED executive, to instigate this model of care, and to provide leadership during the initial planning phase. The ED physician must be involved in influencing the ED medical team in accepting and advocating for the GEDI role and in educating the medical team about interdependent decision making. This medical position is also vital to ensuring that the medical team is educated about geriatric syndrome management and key principles related to this cohort, such as, end of life decision making and advanced care planning. The ED physician is also engaged in research activities related to developing the evidence to underpin clinical care of older persons in the ED. Finally, the ED physician needs to work with the GEDI nursing team to implement evidence-based practice for the older ED patient and on-going monitoring of performance.
GEDI Clinical Nurse Consultant role
The GEDI CNC provides leadership of the GEDI nurse team. This role provides support and guidance to the GEDI team, advocates for GEDI model inclusion in medical and disposition decision-making and develops relevant clinical assessment and decision making guidelines and documentation. The CNC works with the GEDI physician to monitor GEDI service processes and patient outcomes and works with the medical and nursing educators to deliver staff development activities designed to improve the care of older persons in the ED. The GEDI CNC is also the nurse lead for research projects related to improving the management of older persons in the ED.
The incumbent works with the Nurse Unit Manager of ED to recruit, manage and develop the GEDI nursing team. As part of this aspect of the role, the CNC is also responsible for supporting and, where required, educating/developing the GEDI nurses to ensure they meet the requirements of the position. Finding the right fit for the GEDI nurse with aged care or geriatric experience in the ED can prove challenging. To ensure GEDI are able to fulfil the role in the busy environment of the ED, the GEDI CNC works with the NUM to manage staff improvement. View the advantages and disadvantages or using existing ED staff in GEDI roles.
GEDI Clinical Nurse role
The GEDI clinical nurse (CN) is a nurse with education and/or experience in both emergency and gerontological nursing. These nurses are part of the ED team and as such are line managed by the NUM with additional professional guidance and day-to-day support in coordinating activity from the GEDI CNC. As with all CN roles in the ED, GEDI CNs have included as part of their role a specific quality improvement portfolio related to one of the national standards.
NB: Refer to GEDI role descriptions and responsibilities for more details on each role description.
The specific functioning of the CN centres around the GEDI model including:
- Screening, assessment
- Contributing to decision making
- Disposition planning
- Advocacy
- Clinical interventions.
These are now described in greater detail.
