WESTERLY — With about 23% of the city’s population estimated to be at least 65 years old, coupled with a national trend of aging, Westerly Hospital officials predict the number of seniors requiring emergency care will increase. With that in mind, the facility, along with all others in the Yale New Haven Health System, recently earned special geriatric accreditation.
Westerly Hospital and seven other Yale New Haven Health System facilities are now among a small group of health systems across the country to receive Yale Health System Geriatric Emergency Department accreditation. American College of Emergency Physicians designating all eight facilities as senior friendly.
Westerly Hospital’s emergency department saw 11,234 people aged 65 or older in 2021, which accounted for 56% of the hospital’s emergency department volume. According to the US Census Bureau, just over 23% of Westerly’s population is at least 65 years old. The demographics of Washington and New London counties are similar, but both have slightly lower percentages of adults aged 65 or older.
To gain accreditation, emergency department staff and managers at Westerly Hospital and other facilities underwent training to better focus on the physiological differences between the elderly and other patients. Clinicians in the emergency department also discovered and began using the Confusion Assessment Method screening tool for delirium. The tool helps clinicians determine if a patient has traits associated with normal aging, dementia or delirium, which may signal “a new disease,” Niki Akaka, registered nurse and clinical coordinator, said during a recent interview at Westerly Hospital. .
The confusion assessment method involves clinicians asking patients over 65 questions. Determining whether a patient has delirium caused by an underlying condition can be critical, said Bethany Gingerella, nurse manager at Westerly Hospital. “If the screening tool result is positive for delirium, we dig a little deeper to see if there’s an infection that we may not be seeing,” Gingerella said.
While people aged 85 and over are expected to increasingly represent a large segment of those treated in emergency departments, Dr. Nader Bahadory, medical director of the emergency department at Westerly Hospital, said that Doctors and other medical care providers seek to educate each other about the health issues facing older people. .
“They are a special population because their physiology is a bit different. It’s been realized for at least a few years that we have to understand their physiology because we tend to miss subtle things in these older patients…they can get really sick quickly and it’s often a very subtle start,” Bahadory said.
To gain accreditation, the hospital also worked to establish an optimal environment for the elderly by ensuring that room lighting could be dimmed to improve vision and reduce anxiety. The facility has also ensured that a sufficient number of walkers and canes are available, and dietary staff have been asked to help develop meals that will appeal to older people. “Eating is a big thing for them. We don’t want them not eating when they’re with us,” Gingerella said.
Amplifying devices are available for doctors and nurses who work with older people who have impaired hearing, and magnifying devices are available for older people who need help reading. Clinicians also consult with hospital pharmacists to check for potential drug interaction issues.
Overall, the geriatric emergency department program provides specific criteria and goals for clinicians and emergency administrators to target. The accreditation process provides more than two dozen best practices in geriatric care. The goal is to successfully complete the treatment, bring the elderly home, and determine if they need new support, Bahadory said.
As part of the accreditation process, hospitals check records and send data to the American College of Emergency Physicians for review and recommendations.
Other facilities in the Yale system to receive accreditation are Lawrence + Memorial in New London, Pequot Health Center in Groton, Bridgeport (Milford and Bridgeport campuses), Greenwich, Yale New Haven (York Street and Saint Raphael campuses), and Shoreline Medical Center at Guilford.
The designation has been awarded to only 13 health systems nationwide.
Each year in the United States, adults aged 50 and older make more than 40 million emergency room visits, according to a press release from Yale New Haven Health.
“We know that older adults seeking emergency care have unique needs to address symptoms and demands specific to their age group,” said Dr. Ula Hwang, professor of emergency medicine at Yale School. of Medicine and attending physician at Yale. New Haven Hospital. “Through this accreditation process, our providers are trained to look for signs and symptoms of syndromes and conditions in older adults that could potentially be life-threatening if left untreated.”