Impressive Outcomes for Geriatric Emergency Department
January 29, 2016
Going to the Emergency Department is frightening enough, but even more so if you’re a frail senior who is exposed to people who’ve ended up there as a result of gunshots or drug overdoses.
HH&N reported recently about an innovative model of caring that St. Joseph’s Regional Medical Center in Paterson, N.J., has set up to address this very issue. St. Joseph’s Geriatric Emergency Department is focused on the needs of seniors, designed to support their physical challenges, and staffed by individuals specifically trained in providing geriatric care.
The outcomes are so impressive that all hospital administrators should consider developing specialty EDs. Many are.
HH&N reports that 21.5% of all people 65 and older will visit an ED this coming year. That translates to about 10 million elderly patients. Since opening in 2009, St. Joseph’s has experienced a reduction from 54% to 34% in direct admissions from its Geriatric Emergency Department. Patient satisfaction has also increased and return visits decreased.
What About the Physical Environment?
I often write about the lived experience of the physical environment in which patients find themselves. For an elderly person who is not feeling well, and also has hearing impairment, compromised cognition, and is frightened in general of strange situations, the ED can be intimidating and maybe even horrifying.
Isn’t it amazing that the kind of concern and care in pediatric units, children’s emergency rooms, and children’s hospitals isn’t always extended to the elderly? The needs are similar, and outcomes are better if the environment is supportive, safe, and secure — especially for patients who have dementia.
St. Joseph has provided a strong model for other healthcare organizations to consider in caring for elderly patients. More important, however, is to look at current experiences in your ED — the risks that are present for specific patient populations, and opportunities for improvement.
In his many writings about healing environments, Roger Ulrich, Ph.D., suggests to “Eliminate environmental characteristics that are known to be stressful or can have direct negative impacts on outcomes…[and include] characteristics and opportunities in the environment that…can calm patients, reduce stress, and strengthen coping resources and healthful processes.”
Take a look around. Little changes can make a huge difference.
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