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volunteer with charge nurse

Barry Reid, a volunteer at St. Lucie Medical Center’s emergency room, discusses the comfort of the extra-padded bed with Rebecca Armstrong, R.N., nurse manager. GREG GARDNER PHOTO

St. Lucie Medical Center goes the extra mile for geriatric ER patients

BY GREG GARDNER

Patients older than 65 are getting extra-special care at St. Lucie Medical Center’s Senior Emergency Department with a shift in culture and the addition of six rooms designed for comfort.

“We recognized we serve a geriatric population and we want to do right by them,” says Dr. Andres Sasson, medical director at the Port St. Lucie ER. “We were low performing for satisfaction scores and we launched a senior-friendly training initiative and a push for improvement. Of 107 (Hospital Corporation of America) hospitals I am proud to say we went from the bottom 5 percent to the top 5 percent.”

With 118 assisted-living communities within 30 minutes of the ER, senior citizens make up 60 percent of the 43,000 yearly admissions. Silver paint marks the six rooms where senior patients stay while the ER team determines if they should be admitted.

When a senior patient arrives at the ER, the first two questions are: “What is wrong?” and most importantly, “What medication are you taking?” Family members are located and any updates or medication reminders can be texted to them. “We make additional calls in the history gathering process,” Sasson says.

“Seniors have confusion,” says Lex Lalicon, director of emergency services at the hospital’s Darwin Square facility. “They come in and feel afraid and alone. We make them comfortable and decrease the anxiety level. Each patient’s care is complex.”

The ER staff knows, for example, not to address an older woman as sweetie or honey. It’s all part of the sensitivity training being taught to emergency room personnel.

The attention to detail in the senior rooms is impressive. Handrails lead to the bathroom. Next to the bed with an extra-thick mattress is a pneumatic call button, a phone with easy-to-read numbers and a stepstool. Two foldout seats are for family members. All hospital forms are in 18-point type. Pillow speakers for the TV, a blanket warmer and booties add to the comfort level.

If hearing is a problem, there is a device the patient can adjust to hear the doctor. If the patients don’t have their glasses, the box on the wall has glasses with several different strengths. The ER goes through a large box of glasses every month. The high windows were installed specifically to allow patients to know whether it’s day or night.

Each room has a cabinet that opens out to a full workstation. A movable light is available should the room be needed for surgery. The back wall has a dozen different lifesaving tools at the ready.

The six Senior Friendly Care rooms, the first of their kind in South Florida, were added in December 2013 during an expansion of the ER, increasing the square footage from 10,000 to 16,000 and rooms increased from 24 to 35.

Patients from assisted-living facilities present a particular challenge since many who come to the ER are in frail health. However, their records are easily accessible, allowing for faster treatment.

When someone falls and comes to the ER, the team can wheel in a bedside ultrasound, which can show whether there is blood in the stomach, trauma or internal injuries. The doctor can then decide the next course of action.

When someone appears to be having a stroke, Wally, the robotic camera, arrives bedside so a neurosurgeon on call 24 hours a day can zoom in for a close look at the patient. Doctors must have the complete picture and are careful to administer the drug tPA. Tissue Plasminogen Activator — if administered within three hours of the first stroke-like symptoms — can dissipate the threatening blood clot.

Each discharged patient has a case manager who works with family and caregivers to arrange delivery of oxygen, schedule therapy and administer medicines.

Barry Reid, 73, has volunteered two days a week at the ER for the past 10 years. “You want to be in a comfortable place,” he says. “The atmosphere is uplifting. You see smiling faces all around. The staff is very attentive. The quality of the care here is very high.”

“We recognize who we serve and it is a big part of our demographics that we are a high acuity emergency room,” director Sasson says. “It is not just the physical plant. We changed our culture and we have attentive specialists providing good care and a good experience.”