Hospitals give seniors their own ER
FORT LAUDERDALE, Fla. — An emergency hospital visit often equals long waits and noisy controlled chaos, an atmosphere particularly hard on older patients. But Memorial Regional Hospital South is trying something new: giving seniors an emergency room of their own.
The Hollywood, Fla., health care facility is among a small but growing number of hospitals nationwide looking to change the emergency room experience for elders.
Many geriatric emergency departments began as a way for the competitive hospital industry to appeal to the huge baby boom population. Dawn Lipka, Memorial South’s emergency services director, said her program originally was designed to market to the retirement condos nearby.
“We like it when they refer to us as ‘their’ hospital,” Lipka said. “We are smaller, quieter and can give them more personalized attention.”
Geriatric ER boosters are hoping for other benefits: elder patients who are less likely to be back in the ER within a few weeks because no one properly planned for their care at home. Starting next year, Medicare will financially penalize hospitals that have large numbers of patients who must return to the hospital less than 30 days after discharge, in an effort to curb costs and promote better discharge planning.
“These new ERs are a good example of transforming the health care system to meet the specialized needs of a population,” said Cecilia Rokusek, executive director of education, planning and research for Nova Southeastern University’s College of Osteopathic Medicine. “We often have specialized units for pediatrics but we forget about seniors.”
People age 65 and older account for about 12 percent of all Americans, but they make up about 25 percent of those visiting emergency rooms, according to the Centers for Disease Prevention and Control.
Some senior-centered emergency departments have specially designed and furnished rooms within an existing ER, or a separate geriatric wing. Other hospitals have gone with aging specialist teams that can better assess an older patient’s overall health upon arrival and arrange post-ER care, rather than set aside a specific space in their building.
Either way, those in geriatric medicine say the concept could mean better care for patients and better outcomes for hospitals.
Senior rooms at Memorial South — among the three set aside for seniors in the 12-bed ER — have beds that are lower, making it easier to get in and out; soft flooring to cushion falls; and doors instead of curtains. A social worker is assigned to the unit full time to assess what older patients will need when they leave, arranging for services such as home care or delivered meals, and do followups after discharge.
Dr. Joseph Ouslander, a researcher studying hospital readmissions at Florida Atlantic University, called geriatric emergency departments “a great quality-of-care idea.”
“If I ran a hospital and saw a lot of people in my ER who were elderly, I would do this,” said Ouslander, senior associate dean at FAU’s Charles E. Schmidt College of Medicine.
Most emergency rooms are concentrating on getting people out quickly, with some posting real-time estimated waiting periods on interstate bulletin boards, Ouslander said. Instead, geriatric emergency departments could focus on evaluating the multiple chronic conditions seniors can have, he said, not just their immediate medical crisis.
