UCI Health named a top emergency department for senior care
June 21, 2023
Orange, Calif. — The American College of Emergency Physicians (ACEP) has recognized the UCI Health emergency department (ED) and its geriatric emergency team with accreditation as a Gold Level 1 Geriatric ED.
As the only ED in Orange County to receive this top-level designation, it reflects the UCI Health commitment to providing a coherent system of care for older adults using over 20 ACEP approved senior patient focused protocols. It has also led to better outcomes for senior patients, including a 5% reduction in return ED visits and hospital readmissions and an increased connection to follow-up care and other health services outside the ED.
“Patients who are age 65 and older experience specific physiologic changes, are at higher risk for disease processes such as delirium and face additional complications such as cognitive and memory problems, hearing loss, impaired vision and a higher risk for falls,” says Dr. Jennifer Roh, director of the UCI Health GED. “We are here to help identify, treat and also prevent these complications and we are dedicated to teaching our ED teams how to deliver the highest quality acute care for senior patients.”
Roh and nurse navigator Valencia Giles, RN, MICN, created the program with grant funding from West Health, a nonprofit organization focused on successful aging, and guidance from the University of California health system, especially UC San Diego Health, which established the first GED in Southern California.
Wave of the future
UCI Health has long been recognized for excellence in geriatric medicine, regularly ranking among the nation’s top providers of elder care by U.S. News & World Report. While GEDs are still a novel service in healthcare systems, Roh and other emergency medicine physicians with a focus in geriatrics see it as the wave of the future, one that will be increasingly important as the silver tsunami of an aging population swells over the next few decades.
"Our whole population is living longer and living healthier," says Roh. "This accreditation really highlights our commitment to them and the value of a multidisciplinary program."
The GED program coordinates care with ED physicians, APPs and nurses, pharmacists, geriatricians, primary care physicians, physical and occupational therapists, case managers, social workers, translation services and specialty services including trauma and surgery teams. It even works with insurance companies, social service agencies and transportation organizations to elevate care for these at-risk patients.
GENIEs play a key role
A key component of this new system of care are Geriatric Emergency Nurse Initiative Experts (GENIEs) like Giles.
As a nurse with 23 years’ experience in geriatric medicine and the first GENIE at UCI Health, Giles is on the front lines, navigating a multitude of requests from older patients — from pain control and medication orders to expediting follow-up appointments and transportation services.
Giles goes to the bedside while patients are in the ED to begin a comprehensive assessment of the resources they have at home, their cognitive competency and any mobility issues. She also helps them fill prescriptions and understand discharge instructions.
"Taking care of our senior patients is more than just a responsibility, it's an opportunity to show them the love, respect and dignity they deserve as valued members of our society;' says Giles. "Their wisdom, experience and life stories enrich our lives and remind us of the importance of compassion and empathy in healthcare."
In the program’s first year, Giles alone called more than 500 senior patients to ensure they had everything they needed after discharge.
She arranged home delivery of meals to a woman who wasn’t eating every day and lined up translation services for a man who didn’t understand his upcoming surgery. She also scheduled a home visit with Dispatch Health for a patient who lacked transportation and rounded up housing resources for another who was struggling with mental health issues. Giles has even helped patients find ways to pay for a caregiver so they could stay in their homes.
In just two years, the GED has helped thousands of older patients who have come through their doors.
“The past year has really solidified our automated callback system,” Roh says. “It provides translation with real voices in multiple native languages so that every patient aged 65 and above who is discharged from the ED gets a call with several options to get help and ask questions.”
Every patient who asks for help, regardless of the complexity, receives a direct phone call from Giles.
Shifting the paradigm of senior healthcare
“I would love to see the program expand and to encourage more community hospitals to provide senior patient care as the population ages,” says Roh.
She credits the partnership with the UCI Health SeniorHealth Center for many of the program’s successes.
“They provide expert follow-up care and continuing management of patients to prevent unnecessary ED revisits through a variety of specialty services, including assessments for memory, dementia, fall prevention and polypharmacy.”
The SeniorHealth Center has led the way in improving inpatient and outpatient care for older adults. It was among the nation’s first patient-centered medical homes for geriatric care and led the initiative for UCI Health to become an Age-Friendly Health System by the Institute for Healthcare Improvement.
"I applaud this GED designation,” said Lisa M. Gibbs, MD, director of the SeniorHealth Center and a professor and chief of Geriatric Medicine & Gerontology at the UCI School of Medicine. “It demonstrates that we are committed to providing a continuum of age-friendly care for patients in all our clinical settings.”
Dr. Chris Fox, chair and professor of the school of medicine’s Department of Emergency Medicine and a long-time advocate of the GED program, has already implemented plans for an age-friendly ED at UCI Health — Irvine, the new medical complex slated to open in 2025, ensuring a brighter healthcare future for seniors living in coastal and southern Orange County.
UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed, acute care hospital, listed among America’s Best Hospitals by U.S. News & World Report for 21 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook, Instagram, LinkedIn and Twitter.