The Department of Emergency Medicine at The Mount Sinai Hospital is the first in New York State to be accredited as a geriatric emergency department (ED) by the American College of Emergency Physicians (ACEP). Eight emergency departments in the nation received this accreditation, which is part of a nationwide effort to improve and standardize emergency care for elderly patients. Mount Sinai received a Level 1 (Gold) designation -; the highest and most comprehensive level.
“Our geriatric emergency department is leading the way in New York, and we’re proud to receive this recognition from the American College of Emergency Physicians,” said Andy S. Jagoda, MD, Professor and Chair in the Department of Emergency Medicine at the Icahn School of Medicine at Mount Sinai.
According to the Emergency Care Research Institute, geriatric adults (65 and older) account for up to 25 percent of all ED visits, but their needs may not be met in a general ED. In his 2018 State of the State Report, New York Governor Andrew Cuomo set a goal to have 50 percent of all health systems “age-friendly” within the next five years, which would include the establishment of EDs better equipped to provide care to aging New Yorkers with cognitive and physical disabilities.
The ACEP accreditation has three levels with specific criteria, which include having physicians and nurses on staff with specialized geriatric training, ensuring appropriate environmental conditions, and implementing a geriatric quality improvement program.
“Our multidisciplinary team has social workers, case managers, physical therapists, pharmacists, physicians, and nurses who are working together and providing the best possible care to a population of patients with a multitude of needs,” said Denise Nassisi, MD, Associate Professor in the Department of Emergency Medicine at the Icahn School of Medicine and Director of the Geriatric Emergency Department at The Mount Sinai Hospital.
Dr. Nassisi says current protocols for the geriatric ED include having a physical therapist screen patients for their risk of falling, a certified pharmacist review patients’ medication history, and a team of physicians and nurses monitor patients for cognitive dysfunction, frailty, and other ailments unique to this patient population. A special section of the ED has modified lighting with skylights to admit sunlight during the day and dim lighting at night to promote sleep, nonskid flooring, extra handrails to help prevent falls, special mattresses that help prevent bedsores, reduced ambient noise, and curtains designed to minimize noise. Each year, more than 15,000 geriatric patients seek emergency care at The Mount Sinai Hospital, which is preparing to renovate and expand its Emergency Department.
“Mount Sinai’s Geriatric Emergency Department has developed a robust program since the launch of the geriatric ED in 2012, when we became one of the first academic centers in the country to create a unit dedicated to delivering emergency care tailored to the needs of elderly patients,” said Gallane Abraham, MD, Assistant Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai and Associate Director of the Geriatric ED at The Mount Sinai Hospital. “As the baby boomers age, we are seeing more older patients with chronic disease who are living longer and coming to emergency departments across the country, which is why it’s critical to provide specialized care.”
The Department of Emergency Medicine at the Mount Sinai Health System is one of the largest in the country, comprising six hospital-based emergency departments, and is affiliated with Elmhurst Hospital Center, part of New York City’s public health care system. The department has more than 180 faculty members and treats more than 600,000 patients annually. Its research division is ranked No. 2 in the country based on funding from the National Institutes of Health.