Boomer Emergency Rooms

Another burgeoning new trend in healthcare is the advent of geriatric emergency departments geared specifically to boomers and other seniors.

UC San Diego Health, in a partnership with West Health, a nonprofit health organization, is currently designing a state-of-the-art senior emergency care unit to be housed within the future Jacobs Medical Center, a 10-story, expansion of UC San Diego Health’s La Jolla campus that opens later this year.

Largely answering to the fact more than 10,000 baby boomers in the United States turn 65 years of age each day, the new emergency department will focus on geriatric medicine, acute care screening, urgent care, case management, and social and psychiatric care.

With a focus on fostering “successful aging,” the department will also facilitate home- and community-based care options when possible.

“We are delighted to partner with UC San Diego, a leader in aging initiatives, to create an innovative environment for delivering outcomes-based senior emergency care,” said Shelley Lyford, president and chief executive officer of the West Foundation and the West Health Institute. “This model will serve as a catalyst for broader adoption of improved senior emergency care here and across the nation.”

Dr. Vaishal Tolia, an assistant clinical professor at UC San Diego Health whose primary specialty is emergency medicine, told Healthlne that emergency departments are “re-examining the role we play.”

“We are no longer isolated as a separate section,” he said. “We see ourselves now as the central gatekeepers as far as who gets hospitalized, and as a referral point and safety net for all kinds of patients.”

Tolia said his department visited several of the geriatric emergency departments around the country to try to learn best practices.

“We learned that there is no standard to call yourself a geriatric emergency department, there is a lot of variability in places that call themselves geriatric ED’s,” he said. “There are some hospitals that call themselves geriatric EDs, but they do not have a dedicated space or staff. They maybe have a couple of additional things for that patient population but no real established criteria.”

Tolia said a new focus on geriatric emergency departments is improving the overall experience for the patient.

“No one wants to be there and we are want to create a positive, comfortable environment where family can be involved, where we can assist folks that have vision or hearing issues, where patients are safe,” he said. “Just as there are architectural features in pediatric departments, where you see colors, cartoons, things that make it comfortable for a child, we are doing some of the same things with geriatric ED’s including making sure the floors are not slippery and that the acoustic and sound are good.”

In response to this booming trend, the American College of Emergency Physicians (ACEP), American Geriatrics Society (AGS), Emergency Nurses Association (ENA), and Society for Academic Emergency Medicine (SAEM), recently issued a comprehensive set of guidelines covering everything from staffing to education to handling common problems of aging, such as falls, delirium, and dementia.

“Geriatric emergency departments first appeared in 2008, but this is the first time there has been a standardized template for how they should be set up and how care for older patients should be delivered,” Alex Rosenau, president of ACEP, said in a statement. “It is important that the special needs of these vulnerable patients are met appropriately in the emergency setting. As of 2010, there were 40 million people in this age group, and many of them will be emergency patients at some point.”