Geriatric emergency department to focus on rural health
CONCORD, N.H. (AP) — Dartmouth-Hitchcock Medical Center is opening a geriatric emergency department, joining about 100 other hospitals around the country that have implemented similar care.
While most of the others are in urban areas, Dartmouth-Hitchcock is collaborating with group of nonprofit organizations called West Health to focus on the rural population of northern New England. Maine, Vermont and New Hampshire have the oldest median ages in the country.
Over three years, Dartmouth-Hitchcock will develop specialized areas within its emergency department in Lebanon and then use telehealth to expand to four other sites around the region.
“The fundamental issue is the fact that the emergency department is really designed to take of acute events — lacerations, cough, pneumonia, stroke. That works very well for healthy individuals who want aggressive care, however, when you start to talk about geriatric individuals, the reasons they come to the ER are quite varied,” said Dr. Daniel Stadler, the director of the hospital’s geriatrics program. “They may want aggressive treatment, or maybe their family is exhausted. They may be there for a fall, but it’s the 12th fall in the last six months.”
In a geriatric emergency department, staff take a more global approach, looking, for instance, at the reasons behind repeated falls. At-risk patients would be identified through better screening, the environment would be optimized for patients with hearing or vision impairments, and a room would be set aside for patients with dementia, he said.
West Health, which works to lower health care costs to enable older adults to successfully age in place, is contributing $3 million to the initiative, while Dartmouth-Hitchcock will contribute $1.5 million. Tim Lash, West Health’s chief strategy officer, noted that the use of telemedicine to reach patients in rural areas will allow seniors to avoid long ambulance rides and unnecessary hospitalizations.