New protocols and a multidisciplinary team approach is on track to reduce the cost of trauma care by $2 million a year for older patients in Johns-town.
A study of the first five months of operation for Conemaugh Memorial Medical Center’s Geriatric Trauma Institute also showed patients are more likely to be discharged to their own homes after trauma care instead of going to a nursing home or other facility.
Dr. Connie Dela’O, a fourth-year surgical resident at Memorial, presented results of the study Wednesday during Conemaugh Research Symposium at Pitt-Johnstown.
The biggest measurable change showed the average hospital stay for geriatric trauma patients went down from almost six days to about 4.2 days, Dela’O told the audience and judges at Pitt’s Living and Learning Center.
“We are getting patients to the operating room quicker,” Dela’O said. “A surgical resident sees the patient in the ER and they can start calling the specialists.”
Involving emergency responders, primary care doctors, physical therapy, nutrition counselors, occupational therapy, neurology, social services and orthopedics with the staff at Memorial’s Level 1 Regional Resource Trauma Center in the care of every geriatric patient improves care, the study shows.
“Everybody is on board,” Dela'O said. “The whole system is a little more aware of the issues for geriatric patients.”
Dela’O worked with fellow-resident Dr. Anthony Miller, nurses Jami Zipf and Elizabeth Katrancha, along with Dr. Aurelio Rodriguez, director of the geriatric center, and Dr. Russell Dumire, medical director for trauma services.
Results are encouraging, said Rodriguez, who came to Johnstown last year after four decades at some of the top trauma centers in the world, including 20 years at the nation’s first: The University of Maryland R. Adams Cowley Shock Trauma Center in Baltimore.
“We are doing well, and we expect to improve more,” Rodriguez said. “We have accomplished a number of things so far.”
He noted the improvement in length-of-stay and getting patients into surgery sooner.
“I think, in general, we have decreased mortality of many patients,” he said.
The next step will be to expand Conemaugh’s expertise in geriatrics to the surgical arena – specifically, to preoperative management, Rodriguez said. Evaluating older patients’ overall medical condition and taking steps to get them healthier before surgery should reduce complications and death, he said.
The geriatric trauma report was among eight studies presented Wednesday. There were also 10 posters displaying results of Conemaugh’s research program.
“The residents are required to do research and scholarly activity,” said Dr. Jeanne P. Spencer, director of the family medicine residency.
“Physicians need to be aware of research advances, and one of the best ways to understand other research is to do it yourself.”
Dr. D.S. Adams’ presentation on detecting fever in elderly emergency room patients won the top award, with Michael Geishauser’s and Stephanie Thomas’s study on tobacco cessation second and a prostate cancer study by Jill D. Henning, Clareann Bunker and Frank J. Jenkins taking third.
Poster awards went to Neal George and Shriram Sirsikar, first; Rick Kutz and Jenna Stephans, second; and Shilpa Sunkara and Sandeep Yalagadda, third.
Randy Griffith covers health care for The Tribune-Democrat. Follow him on Twitter at twitter.com/photogriffer57.