Elderly patients can deteriorate hourly in the ER. This team works against the clock to get them out
The emergency department of St. Mary’s Hospital in Montreal is a bustling place, especially at 7 a.m. when geriatric nurse Leeza Paolone starts her day. She is focused on the screen in front of her, filled with patient names highlighted in blue. These blue names belong to patients 75 and over who are at risk of functional decline in the hospital. The longer these elderly patients spend in the ER, the worse their outcomes are likely to be due to hospital-associated deconditioning.
Hospital-associated deconditioning is a serious issue for elderly patients in hospital ERs. It refers to physical and cognitive decline that can happen as a result of being hospitalized. Research has shown that one in five patients over 65 developed delirium after spending 12 hours in the ER. Delirium can lead to extended hospital stays, which can have a domino effect on an elderly person’s health and independence.
The geriatric multidisciplinary ER team at St. Mary’s Hospital is working hard to prevent these negative outcomes for elderly patients. The team is proactive in screening, assessing, and treating elderly ER patients to ensure they can be discharged with proper support in place. The team includes a physiotherapist, occupational therapist, social worker, and geriatricians who work together to create individualized care plans for each patient.
One patient, 84-year-old Maria Pastore, has come to the ER with painful bursitis in her hip and a blood clot in her leg. This is her third visit to an ER in a few months, and the team is determined to prevent her from bouncing back by ensuring she receives the follow-up care she needs. With a detailed intake and a care plan in place, Pastore is set up for success with appointments and follow-ups arranged.
Dr. Robert Drummond, an emergency medicine specialist at St. Mary’s, emphasizes the importance of preventing elderly patients from waiting in the ER. Longer waits can lead to higher mortality rates for these patients, making it crucial to provide timely and effective care. The team at St. Mary’s has made a significant impact by reducing the time elderly patients spend in the ER and decreasing the number of admissions.
The team’s approach to geriatric ER care is a model that could be replicated in hospitals across Canada. Dr. Brittany Ellis, an ER doctor and chair of the Geriatric Emergency Medicine Committee for the Canadian Association of Emergency Physicians, highlights the importance of comprehensive geriatric care in the ER. Access to programs like the one at St. Mary’s can improve outcomes for elderly patients and prevent unnecessary hospitalizations.
As the St. Mary’s pilot program continues, the team is seeing promising results in terms of reduced ER wait times and admissions for geriatric patients. The goal is to discharge elderly patients quickly and safely, ensuring they have the support they need to recover at home. By providing proactive and comprehensive care, the team at St. Mary’s is making a significant difference in the lives of elderly patients like Maria Pastore.
In conclusion, the geriatric ER team at St. Mary’s Hospital is leading the way in providing specialized care for elderly patients in the ER. By focusing on prevention, timely interventions, and individualized care plans, the team is improving outcomes and reducing hospital admissions for elderly patients. Their approach serves as a model for hospitals across Canada to follow in order to better serve the growing population of elderly patients.
