The percentage of emergency room visits in the United States that lead to hospital admission is just about 12%, but patients 65 and older are 40% more likely than this average to be admitted to the hospital after an ER visit. In San Diego, more than 25% of all visitors to the UC San Diego Health System emergency rooms are seniors, which is double the typical rate in San Diego. This is why UC San Diego La Jolla, in conjunction with West Health of La Jolla and its parent institutions the Gary and Mary West Health Policy Center in Washington and the Gary and Mary West Health Institute, is building a dedicated geriatric-focused emergency care department. As healthcare providers are gearing up to offer need-specific care to San Diego’s over-65 population, caregivers, loved ones and home care aides need to know why this focus is so important.
The two physicians directing the design of this new facility, Dr. Zia Agha, executive vice president of clinical research and informatics and chief medical officer of West Health and Dr. Ted Chan, the chair of emergency medicine at UC San Diego, say that the new facility is prompted by two realities. First, standard ERs are designed for the entire population, and don’t accommodate the specific concerns that older patients have. Second, seniors simply have different healthcare needs than younger patients do. On average, seniors are greater fall risks, take more medications, and don’t process the disorienting noise and lights of the typical emergency room as well. And they are more likely to be admitted to the hospital for continued care of whatever brought them to the ER in the first place. And, since ERs are all about addressing the acute, current issue, they don’t do much cognitive screening, which can and does lead to return visits to the ER and higher hospital readmission rates as well.
The Gary and Mary West Health Institute, according to its website, is a non-profit medical research organization who mission is to help “seniors successfully age in place, with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence.” The pledge of almost $12 million to build this geriatric Emergency Department at UCSD will allow them to support research of all these trends in senior health and healthcare, and to develop responsive care models.
The Gary and Mary West Senior Emergency Care Unit will be an addition to the general ER, will open in 2018, and will feature the latest in senior-specific environments. The Senior ECU will have natural lighting, not disorienting fluorescents. The floors will be non-slip, and the walls, furniture and décor will employ contrasting colors for clarity. For example, all the chairs will have two-tone upholstery so the eye can easily tell the seat from the seat-back. Also, the supplementary services that patients rely on will be accessible right in the new Senior ECU, such as mobility testing, physical therapy, and a dedicated pharmacy. And since this is 2016, each patient will get an iPad that will let them track where they are in each department’s waiting list, as well as their overall wait time.
In addition to this customized unit, the Wests’ foundation is also funding the installation of geriatric emergency services for older patients system-wide at UC San Diego Health. All older patients at UCSD will benefit from urgent care, acute care screening, mental health, social services, and case management – plus technology that will aid and abet aging in place. We know that San Diego is a great place to live, but this new suite of services at UCSD reminds us that San Diego is a great place to be a senior, too.