Have you ever heard anyone say, “I went to the emergency room and had a great experience?” I doubt it. In fact, quite the opposite is likely true. Most visits to the ER are endless waits with poor communication. One physician assistant said that many ERs can best be described as being “like a war zone.”
The truth is, the national average wait time in an ER to initially be seen by medical personnel is 28 minutes, with another 2 hours and 52 minutes until being sent home, or, if being admitted, five hours and 34 minutes. Add two more hours and 16 minutes to actually get into your hospital bed.
This is over 10 hours! No wonder we all dread going to the emergency room.
Now imagine you are an elderly person, already ill enough to go to the ER. The environment is chaotic and noisy, with beeping monitors, loud voices, people crying and bright lights. It is usually very cold. Now throw in a little dementia, and honestly, an ER can be a special kind of nightmare for the elderly and their families.
But did you know that a small but growing number of hospitals are building emergency room departments specifically for the elderly? Nine years ago, St. Joseph’s Regional Medical Center in Paterson, New Jersey, was one of the first U.S. hospitals to open a geriatric emergency room and now there are more than 150 nationwide.
Since elderly patients account for almost 25 percent of all emergency visits worldwide, it might just make sense to re-think how ERs meet their needs. Plus, researchers found that national visits to emergency rooms by the elderly have increased 34 percent in the last decade!
Physicians and hospitals hope that by providing specialized care to the elderly, they can greatly reduce re-admissions and improve patient outcomes. When Holy Cross Hospital in Silver Springs, Maryland, opened its Senior Emergency Center in 2012, its senior patient satisfaction scores were 95 percent positive.
We all know that people are living longer. The fastest-growing population are those over 90, and baby boomers are turning 65 at the rate of 10,000 per day. This group is far more likely to have ongoing chronic conditions and complex co-morbidities and require longer diagnostic workups. So what would a geriatric-friendly ER look like?
• Smaller designated areas away from the hustle and bustle of the main emergency department.
• Private rooms with simple layouts, soft lighting, non-glare/non-skid floors and quiet music.
• Thicker mattresses to prevent bedsores, which can start in as soon as 4-6 hours for the elderly.
• Being seen by medical personnel within 13-15 minutes.
• Specialized training for nurses as well as hiring geriatric nurse practitioners and geriatric physicians.
• Limiting unnecessary tests or procedures.
• Automatic cognitive screening at intake.
• Automatic review of patients’ total medications.
• Automatic follow-up within 48 hours of discharge and continuing over the next two weeks.
• Social services setting up home nursing services immediately if needed.
After doing a little research, I found out that if a hospital treats at least 50 elderly patients a day or 18,000 a year, they should consider building a senior-specific emergency department. I would be surprised if UF Health Shands Hospital and North Florida Regional Medical Center saw less that 50 elderly patients a day.
I do know that Alachua County has a growing elderly population and more and more older people will be showing up in our emergency rooms. If hospitals want to stay competitive and are looking for ways to prevent re-admissions (since they are now penalized financially for having higher re-admission rates), maybe now is the time to plan ahead for a geriatric-friendly ER.
I am hoping as our local hospitals continue to grow and add more and more specialty centers, they seriously consider building a senior-friendly ER. There are many thousands of seniors and their families in this area that would benefit.
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