Summa Akron City Hospital is taking a new approach to caring for older patients with medical emergencies.
When Rosie Lee Stoudemire recently went to the emergency department with debilitating hip pain, the 72-year-old Akron woman was immediately whisked into a section of the ER dedicated to patients from her generation.
The hospital has been operating a Senior Emergency Department within its ER for patients 65 and older since earlier this year.
A total of 16 of the ER’s 54 beds are dedicated to providing specialized geriatric emergency medicine services for the region’s aging population.
“In emergency medicine, we’re recognizing that older patients have different needs than younger patients,” said Dr. Scott Wilber, medical director of the Senior Emergency Department.
Unlike many of their younger counterparts, older emergency department patients often have other health problems and complications along with the issue that brings them to the hospital.
Even something as common as a sprained ankle can be a quick fix for younger patients but a red flag for falls, balance and coordination issues and other underlying problems for older patients, Wilber said.
The goal of the geriatric emergency department is to address not only the medical emergency but also those other health problems, said Dr. Michelle Blanda, Summa’s chair of emergency medicine.
“For the elderly patients and for their caregivers, they don’t know what the resources are,” she said. “We’re doing more things, trying to integrate things. It’s a more comprehensive way to look at the patient.”
The entire emergency department at City Hospital — which opened last year — has private rooms, anti-slip flooring and other design features that benefit all patients, particularly those 65 and older, Wilber said.
But within the Senior Emergency Department, nurses known as “transitional care coordinators” work with the patients and their families to schedule follow-up care and coordinate recommended services, such as home care or short-term rehabilitation.
“The goal is to try to keep you out of the hospital,” said Christy Folden, a registered nurse who serves as a transitional care and utilization management coordinator in the Senior Emergency Department.
Summa’s insurance arm, SummaCare, also has care coordinators and emergency department navigators in the unit to help patients who are enrolled in the insurer’s Medicare managed-care plans to determine what services are needed after they leave the ER.
Patients can be referred to exercise programs, an at-home visit from a doctor, home care or other services, said registered nurse Pam Massoli, a care coordinator and emergency department navigator for SummaCare. She also follows up with patients after discharge with a phone call to make sure they understood their discharge plan.
Stoudemire’s grandson, Larry Stoudemire, said he liked the fact that there was an area of the emergency department dedicated to older patients when he recently brought her to the hospital for pain.
“We get fast service,” he said. “I like that.”
Keeping patients healthy
The concept fits into an expected shift in the coming years within the health-care industry toward rewarding hospitals financially for coordinating services to keep patients healthy and out of the hospital.
Since opening the Senior Emergency Department within the ER, the hospital reduced the percentage of ER patients 65 and older who end up being hospitalized by 4.3 percent within the first three months of operation compared to the same time period last year.
Slightly more patients (2.4 percent) also were able to go home after visiting the ER than before the geriatric unit opened.
Wilber, who also serves as Summa’s medical director of emergency medicine research, is presenting the findings of the three-month pilot study today during the American College of Emergency Physicians’ annual conference in Seattle.
Wilber estimates about 20 percent of the roughly 80,000 patients seen each year in the City Hospital emergency department are 65 or older.
The Senior Emergency Department has been averaging about 1,100 patients per month.
Patients with trauma, heart attacks or strokes are continuing to be treated in other dedicated areas of the emergency department, regardless of age.
The Senior Emergency Department is operating from 8:30 a.m. to 8:30 p.m., when the majority of older patients come to the ER, Wilber said.
A small but increasing number of hospitals nationwide are running dedicated geriatric emergency departments to provide specialized care to older patients.
In Northeast Ohio, University Hospitals has been operating senior emergency departments within its ERs at Bedford and Richmond medical centers since 2011.
The Centers for Medicare and Medicaid Services also is supporting a three-year national study at three hospitals in Illinois, New Jersey and New York to determine whether geriatric emergency departments improve quality of life, patient satisfaction, annual hospitalization rates and other areas for older patients.
Cheryl Powell can be reached at 330-996-3902 or firstname.lastname@example.org. Follow Powell on Twitter at twitter.com/abjcherylpowell.