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San Diego Hospitals, County Pledge To Improve Emergency Care For Older Patients

Kim Gallo, director of the San Diego County’s Aging and Independence Services, signs a poster board symbolizing a commitment to the San Diego Senior Emergency Care Initiative, Dec. 9, 2019.
Tarryn Mento
Kim Gallo, director of the San Diego County’s Aging and Independence Services, signs a poster board symbolizing a commitment to the San Diego Senior Emergency Care Initiative, Dec. 9, 2019.

San Diego emergency departments want to better serve the county’s older adults. Local health care providers committed Monday to improving care for the region's estimated 430,000 seniors.

Nine hospitals and health care systems signed on to the San Diego Senior Emergency Care Initiative, a public-private effort to ensure a majority of local hospitals have accredited geriatric emergency departments by the end of next year. Advocates say focusing on the needs of older adults and reducing their reliance on emergency services can improve medical care for all patients.

San Diego Hospitals, County Pledge To Improve Emergency Care For Older Patients
Listen to this story by Tarryn Mento.

San Diego’s first certified senior facility, the Gary and Mary West Senior Emergency Care Unit, opened at UC San Diego Health in La Jolla earlier this year. More than a third of the health care system's emergency patients were older than 65.

Chair of Emergency Medicine Dr. Ted Chan said the senior-focused unit has helped keep older patients from returning to the emergency room by looking out for more than just immediate needs.

"Our triage nurses now not only identify acute illness, but they screen patients for their well-being and other issues," Chan said at an event announcing the initiative.

The facility's geriatric nurse specialist may assess if patients need outside referrals, look for signs of early dementia or malnutrition and check for "caregiver strain amongst their family and loved ones," Chan said.

He said preliminary data showed a patient's risk of returning to the emergency department or experiencing a hospitalization within 30 days of their initial visit declined by 12% and 20%, respectively.

The San Diego Senior Emergency Care Initiative aims to expand this specialized care to at least 12 emergency departments. Census estimates show adults 65 years and older account for more than 10 percent of the county's population but officials expect that to double by 2030.

The nonprofit West Health, which helped establish the national Geriatric Emergency Department Accreditation Program, and the county are providing $700,000 to cover some costs for training, equipment updates and accreditation application fees.

West Health Chief Medical Officer Dr. Zia Agha said keeping seniors out of the emergency room has broad benefits.

"Having the opportunity to early intervene and diagnose and then safely transfer patients to the home setting makes a lot of sense to reduce the sort of crowding issues and those metrics," Agha told KPBS.

In addition to UC San Diego Health, Alvarado Hospital recently received accreditation. The two institutions will help guide the other seven facilities as they seek certification. They include Kaiser Permanente, Palomar Health, Paradise Valley Hospital, Scripps Health, Share HealthCare, Tri-City Medical Center and VA San Diego Healthcare System.