https://doi.org/10.4081/gc.2026.14223
Enhancing discharge outcomes through occupational therapy-led geriatric assessment in the emergency department
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Accepted: 24 June 2026
Published: 10 September 2026
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.
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