Advanced age brings special needs, especially in the emergency department. So some hospitals are changing designs and processes for their senior patients.
In August, a 75-year-old Wisconsin woman with chronic leukemia fell and called 911 for the third time in a single day. Paramedics finally convinced her to go to the emergency room. Rather than just tending to her injuries, the attending physician in the ED put her through a new “falls” protocol for elderly adults that included not only blood pressure screening but also a TUG, or “timed up and go,” test, which measures how quickly a patient can stand and walk. When she didn’t want to be hospitalized, the physician also ordered physical therapy for her at home, to initiate a treatment plan, review her home environment and suggest modifications.
The falls protocol at Aurora St. Luke’s South Shore hospital, in Cudahy, Wisc., is part of a larger effort by the hospital’s parent network, Aurora Health Care, to “geriatricize” its emergency departments, says Michael Malone, medical director for senior services for the group of 14 acute care hospitals. Falls are a priority because they account for 10% of emergency room visits for older patients. For elderly adults, they are the leading cause of death from trauma.
Aurora Health Care is a member of the Geriatrics Emergency Department Collaborative (GEDC), a group of nine hospital systems that have been working since 2015 to revamp the emergency care they offer. Funded by $7 million in grants from the John A. Hartford Foundation in New York City and West Health in La Jolla, GEDC aims to add another 50 hospitals over the three years.