Picture the last time you were in the waiting room of an emergency department (ED). I know it’s probably not a fond memory, but bear with me for a moment.
Now, pan across the room and think about the people you see waiting for a doctor. What does everyone have in common – besides being sick or injured?
In all likelihood everyone waiting for treatment was aged 18 or older. Why was that? Well it’s simple; because any children requiring emergency treatment were either at the local children’s hospital or in a special unit – a pediatric ED – of the hospital in which you were sitting.
For decades hospitals have understood the special medical needs of their youngest patients. Pediatric EDs are much different than an adult ED: they’re kid friendly, have specialized and appropriately-sized medical equipment, large rooms for mom, dad and siblings to accompany them, and medical professionals specially trained to treat children and teenagers.
Makes perfect sense – the segregation of a population to effectively, efficiently and appropriately deal with their medical needs.
Now, hospitals across the country are taking the concept of patient segregation a step further with a different age group – the elderly.
Geriatric Emergency Departments, staffed with physicians, nurses and specialists trained specifically to diagnose and care for the elderly, are similar to pediatric EDs in that they are quiet and tranquil – away from the hectic pace of the general emergency room.
According to a recent CNN story, the popularity of these specialized units is gaining traction, with over 100 in operation since 2008 and more planned in California, Texas, North Carolina and Connecticut.
I believe this is only the beginning. As we have seen with their pediatric counterparts, geriatric EDs will demonstrate value by improving quality while decreasing costs – the crowning achievement of every hospital and health system in the country.
Specifically, geriatric emergency rooms will become more common around the country because they will allow hospitals to:
- Improve patient quality scores: While all hospitals want to provide excellent care, soon their bottom line will depend on it. Earlier this year the Centers for Medicare and Medicaid Services (CMS) announced that within two years half of traditional Medicare payments will be based on quality of care rather than quantity of services. With geriatric EDs, individualized and age-appropriate care means happier patients which equates to higher quality scores.
- Reduce readmissions: Another financial hit to hospitals occurs if their readmission rates – meaning the percentage of patients who return back to an ED within 30 days after discharge –are too high.* By having professionals trained specifically to not only diagnose and care for the elderly, but also recognize the signs and symptoms of conditions like dementia and look for indications of elderly abuse, this population will receive improved care and lessen the chance of a return trip to the ED.
- Differentiate themselves from competitors: According to a 2014 report by the National Institutes of Health, “EDs are playing an increasingly important role in the care of older adults” as ED visits – whether necessary or not – increase with age. With the population only getting older – and living longer – those numbers will continue to increase. A hospital with a geriatric ED will stand apart from its competitors to this growing audience. However, since Medicare patients are not the ideal patient base to grow (Medicare payments are so low), hospitals will use the opportunity to put their best foot forward and showcase their services to the rest of the family – who hopefully have private insurance.
As practically every major city has a children’s hospital, perhaps soon we’ll see hospitals for the elderly. Moreover, I bet many hospitals in many cities are looking at the feasibility of a geriatric ED for the future.
* In 2012 CMS finalized policies regarding readmission measures, which included methodology to calculate the excess readmission ratio for each applicable condition. It stated “A hospital’s excess readmission ratio is a measure of a hospital’s readmission performance compared to the national average for the hospital’s set of patients with that applicable condition.” Source