About
The emergency department (ED) is a primary portal of entry
into the hospital and acute health care system for patients. Older adults contribute to a greater proportion of ED visits than younger individuals, and they characteristically present with greater medical acuity and complex medical histories. Despite being the biggest user of emergency services, older adults are at greater risk for misdiagnosis and poor health outcomes within the emergency setting and post- discharge.
Atypical clinical presentations and multifaceted care needs challenge emergency providers to deliver geriatric-sensitive and value-congruent care to the growing number of older ED patients. Further, emergency management and educational pathways have traditionally focused on medical acuity and clinical stabilization, resulting in the under-triage of older adults and clinicians overlooking geriatric syndromes in the ED. Geriatric syndromes are multifactorial clinical or health conditions prevalent among older adults (e.g., cognitive impairment, falls) and are robust predictors of patient-important outcomes for older adults in the ED. Dr. Mowbray uses data surrounding geriatric syndromes to develop and validate assessment items for the evaluation of older adults in the ED, to support emergency care and referral patterns postdischarge.
Dr. Mowbray has published multiple studies and trials evaluating the assessment of geriatric syndromes and needs during emergency care. Further, he has advocated for nursing to take leadership in the domain of Geriatric Emergency Care, as has provided evidence to support their efficacy in identifying geriatric syndromes and accuracy in determining geriatric referral needs for older ED patients. Currently, he is working to develop a self-report instrument to identify those with frailty in the ED and, thus, in greatest need of geriatric services following emergency care.
Dr. Mowbray is a research methodologist specializing in the use of
big data and health records to answer timely research questions concerning nursing care provided for older ED patients. Further, Dr. Mowbray supports the education of statistics and research methods for the College of Nursing, providing consultation to doctoral students and faculty as needed. Dr. Mowbray is currently an Associate Fellow with the United States branch of interRAI ©, where he works with geriatric clinicians, researchers, and methodologists to develop national and institutional assessment items to support the care and evaluation of older adults.