Fourth, a two-day workshop is unlikely to be attended by all key personnel from a site, even when the workshop is at the site. Knowledge acquisition often requires repeated exposures to concepts and data. Furthermore, some components of the GED Guidelines are more readily operationalized if they can be linked to electronic medical records or technological resources to ease the burden of screening. Therefore, the GED Boot Camp initiative is also building a website to archive key concepts, instruments, and calculators, while providing a portal for multiple-site Boot Camp sites and attendees to connect, exchange geriatric QI ideas and resources, view updates in the medical literature, and participate in mentorship.

With support from Aurora Health Systems and University Pittsburgh Medical Centers Health Systems, the first two GED Boot Camps occurred in Milwaukee and Pittsburgh in December 2014 and January 2015, respectively. The Aurora Boot Camp was attended by 40 participants from three eastern Wisconsin hospitals ranging from ED physicians, physician extenders, and nurses to case management workers, geriatricians, hospitalists, and home health and hospital administration. All three Aurora hospitals selected QI projects focused on ED triage nurse risk stratification of older adults and referral to outpatient resources available through home health programs, the Aging Disability Resource Center, and other community resources. The Pittsburgh Boot Camp was attended by 35 wide-ranging participants from three western Pennsylvania hospitals. Their hospitals selected a structured triage nurse-emergency physician delirium screening intervention QI project.

The GED Boot Camp offers the opportunity to gather information and data gleaned from the practical experience of implementing the guidelines, identifying barriers to success as well as potential unintended consequences for those trying to achieve compliance with the guidelines. The attributes, limitations, and adaptable elements of the GED Boot Camp will be explored in coming months, but the organizers believe that with appropriate funding and administrative support, this idea can reduce some of the research-to-bedside knowledge translation delays that occur between publication of guidelines and real world health care delivery. The concept of content-expert guided education tied to a measurable implementation project to improve geriatric care one hospital system at a time has captured the attention of the John A Hartford Foundation. Preliminary discussions are underway to determine if this foundation, in collaboration with others, may facilitate the wider and more efficient dissemination of excellence in geriatric ED care nationwide.

Dr. Carpenter is associate professor of emergency medicine and director of evidence based medicine at Washington University School of Medicine in St. Louis. Dr. Biese is associate professor of emergency medicine and internal medicine, division of geriatrics at the University of North Carolina at Chapel Hill School of Medicine. Dr. Hogan is assistant professor, sections of emergency medicine and geriatric and palliative medicine, at the University of Chicago. Dr. Hwang is associate professor of emergency medicine and geriatrics and palliative medicine at Mount Sinai Hospital in New York City. Dr. Malone is the American Geriatrics Society’s liaison to ACEP. Dr. Melady an emergency physician at the Schwartz-Reisman Emergency Centre at Mount Sinai Hospital in Toronto, Canada.