The emergency department at St. Luke’s Miners Campus recently attained Geriatric Emergency Department Accreditation (ACEP) from the American College of Emergency Physicians, demonstrating a commitment to the highest quality of emergency care for older adults.
To meet ACEP geriatric accreditation requirements, emergency departments must demonstrate that they provide geriatric-focused staff education and apply standardized, best-practice approaches to addressing common geriatric issues. They must ensure optimal care transitions from the emergency department to their home or care facility and engage in geriatric-focused quality improvement projects. St. Luke’s Miners Campus joins St. Luke’s Monroe Campuses, which also has geriatric accreditation.
Justin Binstead, DO, Medical Director, Department of Emergency Medicine at St. Luke’s Miners Campus, and Brittany Garris, BSN, RN, Clinical Coordinator, Emergency Department, led the accreditation pursuit process, which took about two years to complete. Both Dr. Binstead and Garris completed additional education in geriatric emergency care. In addition, the charge nurses on each shift became NICHE (Nurses Improving Care for Healthsystem Elders) certified. NICHE provides educational tools to help nurses meet older adults’ unique health care needs through evidence-based geriatric care. Dr. Binstead continually educates physicians on geriatric care during monthly departmental meetings.
“Staff awareness of the differences between older and younger patients is vital to ensure older patients receive the best care,” Dr. Binstead said. Illness and injury can present very differently in older adults than in younger adults. Emergency staff should take those differences into account when evaluating, diagnosing and treating older adults.
“It’s not just a one size fits all mentality in the ER,” he said. “Just having the awareness that certain medications interact differently might affect your evaluation and treatment recommendations. Also, pain perception and trauma in the elderly are very different. Someone who has a fall in their 80s is a lot different than someone who has a fall in their 30s.”
In addition, the certification process requires applicants to complete a geriatric-specific quality improvement initiative to elevate the level of eldercare. In developing the stepwise plan for proper medication usage, Dr. Binstead worked with St. Luke’s pharmacy, geriatrics, psychology, and toxicology departments. The project aims to reduce chemical restraints, thereby avoiding oversedation, drug-to-drug interactions and other side effects.
Dr. Binstead also closely collaborated with the ACEP Committee Chairman, a published author and expert on pharmaceutical intervention.
“The first thing we approached was finding non-pharmacological interventions,” Dr. Binstead said. “This included such things as lavender patches that are calming and activities for older adults with cognitive impairments to prevent them from becoming agitated.”
The accreditation application required six months of data to be reported showing baseline performance as compared to performance post-geriatric guideline implementation. Data demonstrated a marked improvement in falls and patient safety.