Dartmouth-Hitchcock to open geriatric ER

Partnering with a national group of nonprofit organizations, Dartmouth Hitchcock Medical Center is opening a geriatric emergency department, joining some 100 other hospitals that have initiated similar care.

Dartmouth-Hitchcock, in Lebanon, is teaming with San Diego, Calif.-based West Health to focus on the rural population of Maine, Vermont and New Hampshire, which have the oldest median ages in the country.

Over three years, Dartmouth-Hitchcock will develop specialized areas within its emergency department in Lebanon and then use telehealth to expand to four other sites around the region, officials said.

“The fundamental issue is the fact that the emergency department is really designed to take care of acute events — lacerations, cough, pneumonia, stroke. That works very well for healthy individuals who want aggressive care, however, when you start to talk about geriatric individuals, the reasons they come to the ER are quite varied,” said Dr. Daniel Stadler, director of the hospital’s geriatrics program. “They may want aggressive treatment, or maybe their family is exhausted. They may be there for a fall, but it’s the 12th fall in the last six months.”

In a geriatric emergency department, staff will look at the reasons behind repeated falls. At-risk patients would be identified through better screening, the environment would be optimized for patients with hearing or vision impairments, and a room would be set aside for patients with dementia, he said.

West Health, which works to lower health care costs, is contributing $3 million to the initiative, while Dartmouth-Hitchcock will contribute $1.5 million.