Enhancing Emergency Department Experiences for Older Adults: A Rapid Review (2020-2025)

Objectives Older adults (65+) represent nearly 40% of emergency department (ED) visits in Canada, yet consistently report challenges in care experiences, including communication gaps, long wait times, and a lack of age-appropriate services. This rapid review synthesizes recent evidence on ED interventions that improved older adults’ care experiences. Methods We conducted a rapid review guided by the Joanna Briggs Institute (JBI) convergent integrated approach. MEDLINE, CINAHL, Web of Science, and AgeLine were searched (January 2020-July 2025). Eligible studies examined ED-based interventions for older adults ≥ 65 years and reported patient experience outcomes. Three reviewers independently screened, extracted, and appraised studies using the Mixed Methods Appraisal Tool (MMAT). Findings were synthesized thematically across intervention domains. Results Ten studies met the inclusion criteria (3 randomized/quasi-experimental, 3 qualitative, 2 mixed methods, 2 cohorts). Interventions included multi-disciplinary geriatric teams, frailty-specific pathways, redesigned discharge tools, comfort carts, assistive devices, advance care planning, and elder mistreatment screening. Interventions improved satisfaction, dignity, independence, and perceptions of care quality across four different countries (Australia, Ireland, Netherlands, United States of America). Frailty-focused programs and trauma-informed screening were broadly acceptable when framed respectfully. Structured communication redesigns and environmental modifications enhanced patient trust and comfort. Limitations included small samples and a single-site scope. Conclusions Embedding geriatric expertise, structured communication, environmental supports, and trauma-informed practices improves older adults’ perceptions of ED experiences. Future research should prioritize multi-site evaluations, cost-effectiveness, and integration of patient-reported experience measures into routine monitoring.