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A hospital that listens

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March 30th, 2009

Maryland s Holy Cross opens first ER for seniors

By Michele Harris and Michael G. Williams

It might be a stretch to call a trip to the emergency room pleasant, but that s what people are saying about the Seniors Emergency Center at Holy Cross Hospital in Silver Spring, Md. This six-bay unit is the fi rst emergency center in the nation designed specifically for the needs of older patients.

Like so many new ideas, this one came directly from personal experience. When Holy Cross CEO Bill Sexton heard of his own parents frustrating visit to their local ER in New Jersey, he wondered how older patients were treated in his own emergency room. The hospital started talking with patients and their caregivers to learn what ER care was like for them and how Holy Cross could improve their experience.

Uncharted territory

What they found was that subtle changes in both the ER s physical environment and its staff s approach to care could make a world of difference. Holy Cross administrators decided to venture into uncharted territory a separate ER to serve their oldest patients in the same way that their pediatric ER does their youngest ones.

To develop this new concept, Holy Cross partnered with The Erickson School for Aging Studies at The University of Maryland, Baltimore County, because, as Bonnie Mahon, senior director for senior services at Holy Cross Hospital, says,

They are the experts on aging. e school s director, Dr. Billomas, started his career in emergency medicine before going on to become an international authority on geriatrics, so Thomas felt right at home on the project.

My role was offering them a vision of how you fuse a love of aging and a love of elders with high-quality emergency room care, says Thomas. It was really about bringing these two things together and making them work.

More comfort, less stress

When you come into the Seniors Emergency Center, one of the first things you ll notice is how much quieter it is than a regular hospital, omas explains.

This is important not only because it lowers stress, but also because it facilitates eff ective communication between doctors and patients.

Moreover, the lighting, the flooring, and the paint colors eliminate the glare and harsh contrast that make it more difficult for older people ' to see.

To provide more personalized care, Holy Cross medical professionals, accustomed to the fast-paced, high-impact style of traditional emergency medicine, received specialized training in geriatrics. The biggest challenge was getting the staff to modify their practice to meet the specific needs of older patients, Thomas says.

Together, these changes produce a more comfortable, home-like environment that Thomas feels the medical community has moved away from over the years. Environment is really important to health care and healing, he says. at s what we re trying to get back to with the Seniors Emergency Center at Holy Cross Hospital.

A new approach to ER care

While typical ER treatment focuses solely on what brought the patient to the hospital in the fi rst place, the Seniors Emergency Center focuses on keeping patients from having to return for that problem or for something else in the future. In some cases, that means a pharmacy consultation about a patient s prescription medicines and, in others, scheduling a home health care visit. The big thing that makes us very diff erent from other emergency rooms is our follow-up care, says Mahon.

On many, many occasions, through our social worker follow-up we ve been able to provide our patients with additional resources that they would not have known about before.

By all accounts, patients are delighted with the new ER, with 99% saying that they would recommend the Seniors Emergency Center to their friends. Similarly, 97% of these patients said the center met their comfort needs, and 90% reported a wait time that was either very good or excellent.

You done good!

When the Seniors Emergency Center opened, Mahon invited the people who first shared their thoughts on emergency room visits with the hospital at the start of the process to come see it. Among those who accepted her invitation was a gentleman whom Mahon describes as the critic of the group.

Asking him what he thought of the center, he replied, You done good! It s about time someone listened to us!

People defi nitely are listening. Mahon says she s received many calls from other hospital administrators interested in duplicating Holy Cross s successful creation.

This is something I see all hospitals doing, Mahon says. If they weren t thinking about it before, we certainly have stimulated thinking about how they are treating older patients. What better place to start than with the ER where the majority of patients enter the facility?

Michele.Harris@erickson.com

Michael.Williams@erickson.com

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