It is no secret that every hospital is looking for a competitive edge in the increasingly competitive healthcare marketplace. Ask any healthcare professional about marketing hospitals, and they will tell you the Emergency Department is the “front door” of a hospital. And who are the most vocal users of that ‘front door’? You guessed it, the growing 65-and-over demographic. This market segment has always been an important segment of the healthcare client mix, but this powerful group is growing and becoming more demanding. Let’s be honest, they have different needs that have never before been addressed in the ER environment. That is changing…..
Twenty percent of emergency room visits are people over 65. This number is increasing as the population ages, so the hospital has a strong financial incentive. As with any organization, a satisfied customer (patient) is a repeat customer. The patient who has a positive experience will choose to use that hospital’s services in the future. Even patients who arrive by ambulance can normally choose the hospital they wish to go to. In addition, under the Affordable Care Act, Medicare payments are tied to both the Hospital’s patient satisfaction survey and the frequency of re-admittance. So the hospital has a financial incentive to address this aging population.
The geriatric ER acts like a clinic inside the traditional ER. When a patient enters the ER, the standard triage occurs. If the patient is not in a life-threatening condition and is over the age of 65, they are moved into the geriatric ER. The concept is to create a calm environment for team-based care. To reduce anxiety, the environment may utilize doors instead of curtains which also can ease communication. By having separated exam areas, heating units can be used to keep older patients warm. The area will also contain geriatric chairs that are easier for the older patients to get into and out of, as well as padded mattresses to prevent bedsores.
The team approach brings in a pharmacist and a geriatric social worker. Because of the patient’s routine medications, drug interaction can be a major consideration. By bringing the pharmacist into the team earlier, many issues can be eliminated. The social worker is on hand to aid in resources that might be needed on their return home; Meal on Wheels for example.
Everyone will agree that by reducing anxiety and helping calm a patient, the experience will be a positive one. But there are also medical reasons for utilizing this approach. By utilizing this type of environment a patient can be assessed without the added environmental symptoms that can occur during a typical ER visit. In addition, by utilizing a team specialized in geriatrics, a positive patient outcome can be improved considerably.
Not every hospital will have the space or budgets to create a geriatric ER, but the ones that do will have a huge advantage over the other hospitals in their area.