Original Articles Open access

Enhancing discharge outcomes through occupational therapy-led geriatric assessment in the emergency department

Authors

Published
10 September 2026
Section
Original Articles
DOI
10.4081/gc.2026.14223

Abstract

Occupational therapy (OT) in emergency departments (EDs) plays a vital role in supporting frail older adults, yet traditional OT assessments often lack the multidimensional scope required for comprehensive functional and cognitive evaluation. This study evaluated the association between implementing a modified Comprehensive Geriatric Assessment (CGA) tool, the Mini OT CGA, a structured 8-domain assessment covering cognition, functional ability, falls history, social circumstances, rehabilitation potential, and discharge planning, and discharge-related outcomes within an urban hospital ED. A retrospective pre-post audit compared two 2-month periods: February-March 2020 (standard OT assessment; n=217) and February-March 2021 (Mini OT CGA; n=175). Fisher’s exact tests with 95% confidence intervals and Cramér’s V were used to assess differences in ED therapy codes, discharge destination, and community service utilization, with the Benjamini-Hochberg adjustment applied to control for multiple post hoc comparisons. Demographic characteristics were comparable between cohorts. Following implementation of the Mini OT CGA, cases recorded as “No Capacity in Team/Ward/Unit” decreased from 28.6% to 6.9% (adjusted p<0.01; Cramér’s V=0.32), and discharges home with Rapid Response Team support increased from 5.1% to 12.6% (adjusted p≈0.01; Cramér’s V=0.26). Although statistically detectable, these effects were of small-to-moderate magnitude. The structured assessment was associated with improved identification of functional, cognitive, and social needs; more consistent discharge planning; and increased utilization of community-based pathways, without an increase in acute admission rates. These findings suggest that embedding a multidomain geriatric assessment into routine OT practice in the ED is feasible and may support incremental improvements in care coordination for frail older adults. Further evaluation should explore long-term outcomes, readmission risk, and cost-effectiveness to determine broader applicability across diverse healthcare settings.

Keywords

Ethics Approval

This study was registered and approved as a service evaluation by the hospital’s research ethics and governance committee. In accordance with NHS Health Research Authority guidelines, formal written consent was not required, as the project involved retrospective review of anonymized, routinely collected clinical data.

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