Editorial
Is This Really an Emergency? Reducing Potentially Preventable Emergency Department Visits Among Nursing Home Residents

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Scenario One

Mrs Smith, a 92-year-old woman with moderately advanced Alzheimer disease is found in her NH room on the floor by a certified nursing assistant. The registered nurse is called and finds her vital signs to be normal, her mental status to be at her baseline, and no evidence of injury. Based on the NH's policy, the nurse calls 911 and Mrs Smith is transported to the local hospital's Emergency Department (ED) for further evaluation. In the ED, Mrs Smith's vital signs are normal, and the ED

Scenario Two

Mrs Jones, a 92-year-old woman with moderately advanced Alzheimer disease, is found in her NH room on the floor by a certified nursing assistant. The registered nurse is called and finds her vital signs to be normal, her mental status to be at her baseline, and no evidence of injury. Based on the NH's policy, the nurse carefully records her findings on a structured progress note, and initiates the NH's post–fall protocol for such occurrences that includes checking vital signs, mental status,

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    J.G.O. is a full-time employee of Florida Atlantic University (FAU) and serves as a consultant to Think Research. He has received support through FAU to conduct research evaluating the Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program from the National Institutes of Health, the Centers for Medicare and Medicaid Services, The Commonwealth Fund, the Retirement Research Foundation, PointClickCare, Medline Industries, and PatientOrderSets (now Think Research). J.G.O. and his wife have ownership interest in INTERACT Training, Education, and Management (“I TEAM”) Strategies, a business that has a license agreement with FAU for use of INTERACT materials for training and management consulting. J.G.O.'s work on INTERACT-related projects is subject to terms of Conflicts of Interest Management plans developed and approved by the FAU Division of Research Financial Conflict of Interest Committee. J.F.S. has funding from the Centers for Medicare and Medicaid Services for work on the INTERACT Quality Improvement Program. J.H. declares no conflicts of interest.

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