Two months ago New York City's Mount Sinai Hospital opened the doors on its new geriatric emergency room, which is specifically designed to cater to the needs and particular medical issues of patients aged 65 and older, according to a report in The New York Times this week. A part of the Affordable Care Act of 2010 calls for hospitals' Medicare payments to be tied to patient satisfaction surveys and readmission rates. The geriatric ER is designed to improve scores and reduce readmits.
Mount Sinai’s patient satisfaction scores for those in the new ER are “off the scoreboard,” Dr. Andy Jagoda, Mount Sinai's chairman of emergency medicine told the Times. The facility, which has just eight beds, also offers quieter rooms (no metal curtain rings), non-slip floors, an artificial skylight that turns dark at night, and an iPad at every bed. Dr. Jagoda told the newspaper that the stripped down iPad, which he calls the geriPad, is one of his favorite innovations. The device enables patients to have two-way video conversations with nurses and also offers touch screen buttons to ask for lunch, pain medication, or music.
Typically about 27 percent of older patients treated in the ER are readmitted within three months of being sent home. While the new geriatric ER only admits patients with relatively less severe conditions -- broken hips but not heart attacks -- they have reduced readmissions to 1 percent in some cases, according to the report.
The team at St. Joseph’s Regional Medical Center in New Jersey, which has served as a model for other geriatric ER initiatives, has reduced unscheduled return visits to the ER to 1 percent of cases, down from 20 percent. One reason is they have increased scheduled return visits by checking in on patients after discharge and bringing them back in if conditions appear to be worsening.