San Carlos Apache Healthcare Corporation Advances Geriatric Emergency Care Through Accreditation
The Indian Health Service (IHS) Division of Nursing Services, in collaboration with the Alzheimer’s Grant Program, is working to expand Geriatric Emergency Department (ED) Accreditation across IHS and tribal facilities. Since 2022, IHS has supported nine IHS and tribal emergency departments in earning geriatric ED accreditation, made possible through generous philanthropic funding.
Arizona's San Carlos Apache Healthcare Corporation (SCAHC) marked significant milestones in increasing its ED accreditation over the last two years. In 2022, it earned a bronze-level accreditation from the National Geriatric Emergency Department Accreditation (GEDA) Program, which IHS promotes.
SCAHC continued its work this year by applying to advance to silver accreditation.
The GEDA Program is a voluntary program and recognizes emergency departments that deliver high-quality geriatric care. The strict standards set by each organization ensure that they have the resources, expertise, and protocols to effectively meet the specific needs of older patients.
“GEDA accreditation demonstrates a commitment to providing specialized care for older adults, addressing their unique needs and medical conditions,” said David Weech, Director of Emergency Medicine at SCAHC.
The bronze level is the first tier in a three-level accreditation system. To reach this level, the SCAHC implemented targeted improvements, including:
- A pharmacy-led process to review medications for older adults and those taking multiple medications.
- Increasing easy access to mobility aids like walkers and wheelchairs in the emergency room.
- Geriatric-specific policies to guide patient care.
The bronze level provided the SCAHC with a foundation to improve the emergency department experience for older adults and their families. With the silver-level application under review, the SCAHC aims to expand on its improvements. Weech hopes to add additional training, specialized equipment, and partnerships with geriatric care experts to its emergency department.
The San Carlos Apache Healthcare Corporation’s commitment to excellent elder care improves each patient's well-being and builds trust and confidence among the people it serves. “By applying protocols and guidelines to minimize medical errors and adverse events, GEDA-accredited hospitals can improve patient safety,” said Weech. Achieving bronze-level accreditation and striving for silver solidifies SCAHC’s role as a leader in geriatric care.
Find more information on GEDA and other accreditation program information on the IHS website.
Health Insurance Literacy and Its Impact on Medical Care Among American Indians and Alaska Natives
Rebecca Carrillo, a Case Manager at the Phoenix Indian Medical Center, focused her project on the challenges of health insurance literacy. For elderly individuals and their families in American Indian and Alaska Native communities, understanding and navigating health insurance can be overwhelming and create obstacles to receiving care. To explore these issues, she chose a case-study approach to find practical solutions and insights.
Clinical Pearls from her project were:
- Poor patient health insurance literacy contributes to suboptimal care, barriers to care coordination, and delayed outpatient treatment.
- Services like telemedicine, smartphones, and access to electronic health records can improve patient access but can be challenging for low-literacy patients, especially those without social support.
- Case manager proficiency in navigating health insurance and helping patients navigate their insurance can aid with advocacy, education, and closing health disparity gaps for American Indian and Alaska Native patients.
“Case management is a specialized area of nursing focusing on care coordination and health care resources,” said Carillo. “Providing resource information to improve health literacy promotes autonomy in self-care, engagement in complex disease management, and increased health care utilization.”
Carrillo also identified potential policy implications as part of her project, including recommendations for annual case management competencies for nurse case manager educators and the development of geriatric-specific case managers for patients and families with dementia or complex comorbid conditions.
As part of the Indian Health Geriatric Nurse Fellowship program (GNF), participants like Ms. Carillo develop projects or activities that are presented at the close of each Geriatric Nurse Fellowship cohort. For more information on future opportunities, visit the Indian Health Geriatric Nurse Fellowship Program page on the Alzheimer’s Program website.
Nurse Fellows through poster sessions and meet-ups.
