The Dupont Hospital Geriatric Emergency Department was the first geriatric emergency department in Indiana to be recognized by the American College of Emergency Physicians with a Level 1 Geriatric Emergency Department Accreditation (GEDA).
“On average we see about 16,000 patients per year in the ED. Roughly, 25% of those are over the age of 65,” Dr. Andrew Offerle, MD, said. Adding, “On a typical shift the average nurse-to-patient ratio is, one nurse for every two patients.”
A geriatric emergency department family visit
Offerle, is the medical director of the Dupont Geriatric Emergency Department. In that role, he oversees the medical function and features of the thriving Lutheran Health Network geriatric ED. However, after a recent trip to the emergency department with his elderly parents, Offerle saw from a different perspective the care and treatment that patients receive.
“My parents are in their upper 80s. From my standpoint, what is most important is the quality of care they got,” he said.
As a family member, he saw how the staff focused on treating his parents’ larger concerns as well as the medical matter that initially prompted them to visit the emergency department.
“Every single nurse we have in our ER goes through extensive geriatric-specific education. This includes age-appropriate language and age-appropriate medications for seniors. Everyone that is working there, including our technicians, has had a higher level of education than if you were working in a normal ER,” Offerle said.
Age-related senior assessments
Geriatric nurse navigators begin by asking the obvious questions about what brought a patient to the ED. Their questions center on how to treat the whole patient and prevent a return visit. These questions explore the patient’s daily life. Questions about medications and access to health care help staff evaluate patient needs.
Finally, geriatric nurse navigators ask questions about how patients will manage care at home after initial treatment in the emergency department. These questions help assess an ongoing home situation.
Only in a geriatric emergency department
“Things like that are what I noted that you don’t get other places. Typically, (in other places) you will get your problem addressed and then (the medical staff) will send you on to wherever they need to send you,” Offerle said.
Achieving a Level 1 GEDA accreditation requires clinicians and administrators to meet more than two dozen best practices for geriatric care.
These requirements include:
• Geriatric-appropriate equipment and supplies
• Staff specially trained in geriatrics
• Routine screening in place for delirium, dementia and fall risk
Providing senior-focused service
Focus on a geriatric ED at Dupont came about because Lutheran Health Network leadership saw a growing community of older adults who could benefit from a specialized setting that was capable of meeting the multiple needs seniors often have when visiting an emergency department.
“It really came from the growing need we saw in our community. As our population ages they have different needs than the other patients we have. We thought it was something good to do. Not just from a business standpoint but also from a community standpoint. We were just meeting a need that had not yet been met,” Offerle said.
Ancillary surroundings can make all the difference and increase patient comfort. Senior-friendly rooms in the Dupont emergency department feature beds with thicker mattresses, room temperature controls, non-slip floors, large-faced clocks and seating for family members.
“We provide written material in larger fonts so patients can read documents easier. Specialized beds that are the right height for geriatric patients. We have bigger, more comfortable chairs, larger signage and specialized enhanced lighting,” he said.
Treatments and procedures
While many of the tests and procedures for treating various medical issues may be the same for all patient populations, regardless of age, there is still a difference when administering these tests and procedures in a geriatric emergency department.
“I like to say, it is easier for you to get the test that you need because we are more focused on your needs when you are over 65, even if you are getting the same type of procedure. It won’t necessarily be different medical equipment, but it is the ancillary equipment that is different,” he said.
Today, an ever-increasing number of people are joining the ranks of other seniors in the community. The Dupont geriatric emergency department strives to provide a place older citizens can get emergency medical attention. Fortunately, the ED surroundings also strive to be as comfortable as possible while addressing their needs.
“We have grown in the numbers of patients we are servicing. “We are growing and continuing to meet the needs of patients over 65,” Offerle said.