Dartmouth-Hitchcock Medical Center has announced a $4.5 million plan to create what it says is the country's first geriatric emergency department in a rural area.
The hospital is working with the California-based non-profit West Health on the project. West Health, which has worked on similar projects in urban settings, will spend $3 million on the project. Dartmouth-Hitchcock has committed an additional $1.5 million.
The new geriatric emergency department will not be a separate facility at Dartmouth-Hitchcock in Lebanon, rather it will be a series of changes to the existing ED. Those will include renovations, new policies, and about a half-dozen new staff geared toward geriatric patients.
According to Dartmouth-Hitchcock, patients over 65 made up about a quarter of all emergency visits to the hospital in 2017.
Dr. Daniel Stadler, Dartmouth-Hitchcock's Director of Geriatrics, says the current design of most EDs is not well suited for elderly patients. EDs are designed to treat acute conditions, he says, while many elderly patients arrive with chronic illnesses like dementia.
Stadler used an example of an elderly patient with dementia who makes repeated trips to the emergency department.
“The ED is geared to work up 'is something new?'” said Dr. Stadler, “and so she gets a head scan and she gets a urine analysis and she gets a chest x-ray, when what she needs is medication at home.”
Dartmouth-Hitchcock plans to roll out some of the changes by the end of this year. They hope to have the geriatric ED fully accredited by the American College of Emergency Physicians sometime in 2020.
Once that happens, Dartmouth-Hitchcock plans to launch a tele-medicine service out of the geriatric ED to connect its staff with four different hospitals around northern New England.