The Geriatric Emergency Service is the first, and still unique in Italy, emergency and health emergency service (First Aid Point) dedicated to older patients with acute problems or exacerbation of chronic diseases. Patients might access in two ways:
1) via the territorial emergency medical network (118) patients over 80 years with urgent medical and / or surgical (non-traumatological) problems refer
2) spontaneous access is also guaranteed for adult patients (> 14 years), preferably elderly (over 65 years)
The natural catchment area is represented by older patients residing in the urban area of Ancona
Patients receive immediate evaluation of clinical severity (triage) by specialized nursing staff, with the attribution of the color code, which establishes the priority of entry into the examination room; early pain assessment and treatment is standard; preferential fast track and nursing see & treat courses are being activated.
The medical evaluation (carried out by specialists in geriatrics or internal medicine with specific continuing geriatric training), as well as oriented towards emerging (acute) diseases, takes into account functional (mobility, self-sufficiency), cognitive aspects (presence of dementia and / or delirium) and social aspects of the patient, as well as the geriatric specificities in the presentation of diseases (comorbidities, atypical presentations; role of polypharmacy and adverse drugs effects). The rapidity of the diagnostic process is guaranteed by the preferential access to the Laboratory Analysis, Radiology, Digestive Endoscopy and Pneumology services, as well as to the advice of other medical specialist
The structure is equipped with an external waiting room with thirty seats, two clinics dedicated to medical examinations (both equipped with multi-parameter monitors), two waiting rooms for stretched patients and six beds of Observation Unit (OBI). During the COVID 19 epidemic, an additional external, isolated, with negative pressure, examination room was equipped with a multi-parameter monitor and video surveillance
After appropriate evaluation, the patient can be addressed differently:
- discharge home with adequate therapeutic indications, in collaboration with the GP
- admission to one of the INRCA specialized operating units
- transfer to another facility for specific problems
- entry into Observation Unit

Observation Unit (OBI)
This section, equipped with 6 beds, is dedicated to the management of patients who are not immediately discharged, but who possibly do not need hospitalization, being able to benefit from a rapid and intensive diagnostic pathway (aimed at defining and stratifying the acute problem) and / or of a short-term therapy in order to stabilize or resolve the emerging problem, so they can probably be discharged within the following 24/48 hours)
The OBI works in continuity with the clinics and also has the characteristics of a Semi-Intensive Unit with high turnover, aimed at stabilizing the patient's clinical conditions before transfer to the ordinary hospital wards. In addition, it is equipped with an isolation room (with negative air pressure) for patients at risk of infection or with agitated delirium (delirium room). The COVID 19 emergency also led to the creation of an additional room (2 beds) of isolation, with negative air pressure and monitored
At the end of the OBI course, the patient can be discharged at home or admitted to the ordinary hospital wards. Collaboration is active with the palliative care program (Dignity Care) to respond to the special needs of patients with advanced disease
The Service is active 24 hours a day, 7 days a week, 365 days a year

Ticket payment
Accesses to the Geriatric Emergency Service characterized by low severity and not followed by hospitalization (defined "white code") are subject to the payment of a fixed fee (ticket) of € 25. For all other accesses, no ticket payment is required

The Unit (OU) of Geriatrics admits patients mostly from the emergency room, with an average age of 85 years, and it provides services related to the management of acute and chronic-degenerative diseases of the frail older person. These are often very old patients, with multimorbidity and consequent polypharmacy, geriatric syndromes (falls, delirium, rapid functional decline, pressure ulcers), a high degree of disability and at risk of worsening functional status and therefore a high need for medical assistance and nursing. The goal is the stabilization / resolution of diseases trying to prevent further disability and delirium and promoting functional recovery
The ward has twenty-four beds for ordinary hospitalization and includes a an outpatient clinic
The geriatric outpatient clinic deals with:
- geriatric evaluation to optimize the management of multimorbidity and polypharmacy
- evaluation of psycho-affective and cognitive problems in old age (cognitive deficits, anxiety, depression, dementia, behavioral disorders associated with dementia)
- assessment of falls and / or osteoporosis
- geriatric evaluation for the promotion of healthy aging
- follow-up visit after an acute admission to prevent rehospitalization
- certification of functional disability to request disability allowance

Geriatric Outpatient Clinic can be accessed by booking a visit via the Regional appointment center or by direct booking by the doctors of the ward. To carry out the visit, a referral from the primary care physician is required

Geriatric Outpatient Clinic: from 8.30 a.m. to 1.00 p.m. from Tuesday to Friday (times may change in relation to the progress of the coronavirus epidemic)
Visit: from 7.30 a.m. to 9.30 a.m. and from 12.30 p.m. to 8.00 p.m. every day (times may change in relation to the progress of the coronavirus epidemic)