GEAR 2.0 Priorities – Care Transitions

Approximately 50 percent of people living with dementia (PLWD) are discharged to their homes after receiving emergency department (ED) care, but approximately 40 percent of PLWD discharged will experience an adverse event (ED revisits, other hospitalizations, or death) in the 30 days following discharge—a rate significantly higher than for those without dementia. The Care Transitions Work Group (WG) decided that the scope of its PICO-driven literature review would:

  1. focus broadly on studies addressing cognitive impairment (not studies detecting only dementia, because in some studies dementia diagnoses are unknown), and
  2. target studies that address the ED-to-home or ED-to-community transitions.

The Care Transitions WG identified two key PICO questions to the literature review.

  • PICO-1: What interventions delivered to ED patients with impaired cognition and their care partners improved ED discharge transition?
  • PICO-2: What measures of quality ED discharge transitions are important to varying groups of ED patients with impaired cognition and their care partners?

Top Research Priority Areas

The top voted care transitions research priority areas ranked during the 2021 GEAR 2.0 Consensus Conference based on the scoping reviews are as follows: