ELMHURST HOSPITAL CENTER

A major restructuring of geriatric services has been in process at Elmhurst Hospital Center. The goal was to examine patient care needs and design a comprehensive service line as the areas Elmhurst serve comprise the highest concentration of seniors age 65 and over in New York City. The first step culminated in a new outpatient clinic design. The clinic, (the Senior Care Center), opened in September of 1999. The Medical Director of Ambulatory Care Services, Rand David, MD, directs and oversees the clinic's medical structure. The unit chief, Shivkumar Tejwani, is a geriatrician and oversees its Monday through Friday clinical services. The eight assigned physicians are all full-time Mount Sinai affiliation attendings at Elmhurst Hospital who dedicate a specific session(s) to Senior Care. The physicians and two full-time registered nurses work as an interdisciplinary team to provide patient assessment and intervention. Staff are bilingual in Chinese, Korean and Spanish. Presently, the clinic operates morning sessions only.

The second step focused on developing an acute care geriatric unit. The unit opened August 2000. Two geriatricians serve as unit co-directors, Perry Starer, MD and Tita Castor, MD. The geriatricians provide interdisciplinary team leadership and guidance as well as specialty consultation. Within the past year, the geriatric unit has enhanced patient care via a uniquely designed Patient Care Associate training program to augment patient mobility and an on site direct physical therapy assessment program.

These two distinct areas of service were joined within one programmatic administrative structure. This allowed for optimal development, coordination and strengthening of services provided to patients during hospitalization as well as post discharge. Mutual services include "The Caring Connection", a program developed for the at risk socially isolated under and uninsured senior identified within the inpatient unit or Senior Care Center and a United Hospital Fund supported Volunteer Program, "Healthy Outlook". "The Caring Connection" purpose is to provide transportation and if needed volunteers who serve as companions during clinic visits. Additionally, "Healthy Outlook" volunteers conduct group and individual activities geared toward reducing anxiety on the inpatient unit.

Within a three year span, the Senior Care Center has its own unduplicated population of more than 900 patients for whom over 3400 visits will be provided for fiscal year 02. The Center as part of its philosophy, conducts patient activities that are informative and emotionally healing. Informational workshops specific to aging issues as well as creative theatre, art and music have been incrementally added to the overall geriatric services structure. Clinical services have expanded to include Psychiatry and Dietary. A Clinical Nurse Specialist will begin developing geriatric standards of nursing practice institutionally through partnership with New York University via the John Hartford Foundation's "Partners for Dissemination of Best Nursing Practice in Care of Older Adults Program".