Holy Cross Hospital's investment in an eight-bed Seniors Emergency Center in Silver Spring, Md., increased hospital visits. But some doubt that will pay off for the hospital.
The hospital saw a 28% increase in the number of seniors visiting in the last six months of 2014—a total of 7,295—compared with a similar period the previous year. That sounds promising for revenue.
But Dr. Mark Rosenberg, chief of the geriatric emergency department at St. Joseph's Regional Medical Center in Paterson, N.J., noted that visits to the geriatric ED reduce admission rates. Only 43% of geriatric visitors to its senior emergency center were admitted to the hospital, down from 54% of geriatric ER visits the year before it opened.
Decreased use of Foley catheters lowered urinary sepsis and use of thick mattresses prevented bedsores, he said, thereby reducing admissions or shortening stays. One additional benefit: It reduced readmissions and penalties under Medicare's 30-day readmissions reduction program.
Holy Cross CEO Kevin Sexton said it is difficult to attribute savings to geriatric emergency departments without a proper control group. “There are so many moving parts,” he said.
While a number of hospitals have implemented geriatric EDs and are collecting information, “There's not a lot you can point to to say, 'Hey, your ROI is going to increase,' ” said Robert Maliff, director of Plymouth Meeting, Pa.-based ECRI Institute's applied solutions group.
That's one reason why geriatric EDs made ECRI's 2014 Top 10 Hospital C-Suite Watch List, which highlights technologies most likely to affect patient safety, care delivery and capital expenditures.