Is a senior-specific ED in your hospital's future?

Photo by Jacob Wackerhausen/Thinkstock Elderly patients are more frequent users of the ED.

As we've heard over and over, the population of the elderly is, well, booming. The Centers for Disease Control and Prevention projects that persons 65 years and older will double to 89 million by 2050.

As more frequent users of an emergency department (ED) than the rest of the population, will hospitals need to redesign their EDs to accommodate the special needs of elderly patients?

It's early in the game, but the answer appears to be: "Yes." A growing number of hospitals have either built EDs that offer senior-specific patient care or have one in the development stages, according to a report by ECRI Institute, Plymouth Meeting, Pa., in its recent "Top 10 Hospital C-Suite Watch List."

While there is no official count of the number of senior-specific EDs, health care industry reports show that more than 50 have opened across the United States since 2011. An estimated 150 are in development, ECRI reports.

The growth makes sense and is likely to continue for a number of reasons, says Thomas E. Skorup, FACHE, vice president, applied solutions, ECRI Institute.

Elderly patients are more frequent users of the ED and are more likely than the rest of the population to suffer from chronic or degenerative diseases, cognitive impairment and other age-related problems.

Senior-specific EDs usually include features like nonskid floors and handrails to prevent falls, thicker bed mattresses to prevent ulcers, a quiet environment and special lighting to make elderly patients as comfortable as possible. In addition, specially trained ED staff that can work with the elderly are critical to improving outcomes, Skorup says.

Whether a hospital or health care facility decides to build or expand an ED for senior-specific care or makes design adjustments to its existing ED to better accommodate elderly patients is something each facility will need to decide, Skorup says.

"From a planning perspective, many of the attributes of a senior-specific ED are attainable without creating a new space, without creating a new department," Skorup says.

The advantage to making design enhancements to an existing ED is that it would benefit all patients regardless of age, he adds. "I believe that many of the infrastructure changes, such as improved lighting and noise reduction, will find their way into more standard ED [designs] over time," he says.

Infrastructure aside, it is essential that protocols, procedures and staffing expertise are in place so an ED will improve outcomes for elderly patients by reducing needless admissions or readmissions, he emphasizes. Early reports have been positive, ECRI officials say.

Because designing EDs that are safe, quiet and comfortable benefits all patients, Skorup expects the ED initiative to grow, whether it's targeted for the elderly or not.

But he also anticipates that some hospitals will use a senior-specific or enhanced ED as a marketing tool to differentiate themselves from the competition.