Our Care for Older Patients Is ‘Excellent,’ & We’re Making It Even Better

Age is only a number, it’s often said. But when it comes to caring for older patients, some numbers are truly significant because they tell a more enlightening story. Take the number two, for example. That’s the ranking U.S. News & World Report has awarded NYU Langone Health—out of 4,515 hospitals nationwide—for the quality of our geriatric services. NYU Langone also earned a rating of “excellent” among older patients for its 30-day survival rate after admission, frequency of discharging these patients directly to their homes, high nurse-to-patient ratio, and supportive patient services.

“Our hospitals have outstanding metrics for older patients because of an extraordinary system of quality and safety measures that we’ve developed over the years,” notes Joshua Chodosh, MD, the Michael L. Freedman Professor of Geriatric Research and director of the Division of Geriatric Medicine and Palliative Care at NYU Grossman School of Medicine. “Our reputation speaks to the excellent practitioners we have across the board, in both inpatient and outpatient services.”

At the same time, Dr. Chodosh is mindful of some sobering statistics about older adults, including their growing numbers and their vulnerabilities. Among them: by 2034, for the first time in our nation’s history, adults older than 65 are projected to outnumber children under 18. NYU Langone is tackling the challenges posed by an aging population head-on, implementing a host of new programs and initiatives designed to further augment and enhance its care of older patients. Last fall, the division received a $54 million federal grant to lead a study involving 82 hospital emergency departments (EDs) nationwide with the aim of improving emergency and post-emergency care for patients with dementia and their care partners.

“We are totally data driven and supported by our outstanding Medical Center Information Technology team,” says Dr. Chodosh. “Our innovations for these patients will continue to raise the bar for quality and safety.”

Fact: One in Five Americans Will Be Over Age 65 by 2030

Initiative: An Optimal Aging Institute Designed to Add Years of Life and Life to Years

The best way to add luster to the golden years is to stay healthy. That’s the premise of the new Optimal Aging Institute, established with the conviction that many age-related diseases can be prevented by modifying key risk factors: smoking, sleep, diet, exercise, blood glucose, weight, lipids, and blood pressure. The institute’s mission is to build a hub that creates and connects world-class multidisciplinary teams of clinicians and scientists to fuel discovery research through shared resources. Its inaugural director, Josef Coresh, MD, PhD, an expert on vascular health and its connection to cognitive decline, defines optimal aging as “attaining a higher level of functional independence earlier, retaining it longer, and losing as little independence as possible—and it can start at any age.”

Fact: Nearly Half of America’s Older Adults, More Than 26 Million People, Have Prediabetes

Initiative: A Trial That Aims to Stave Off Diabetes

A diagnosis of prediabetes is a startling wake-up call and a prime opportunity for patients to change course so that they don’t join the ranks of the 15.9 million adults 65 and older who have type 2 diabetes. NYU Langone researchers are conducting a randomized trial to compare the effectiveness of two distinct strategies for counseling the more than 15,000 patients at NYU Langone who have prediabetes. The study—called BRIDGE, for BRInging the Diabetes Prevention Program to GEriatric Populations—compares in-person education sessions to teleconferencing ones. Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the trial is led by Jeannette M. Beasley, PhD, RD, MPH, and Dr. Chodosh. Dr. Beasley is an associate professor of medicine at NYU Grossman School of Medicine and associate professor of nutrition and food studies at NYU Steinhardt School of Culture, Education, and Human Development. Learn more about the BRIDGE study.

Fact: One out of Two People Who Are 65 or Older Visit an Emergency Department Every Year

Initiative: Creating a More Age-Friendly Emergency Department

“The front door of the hospital healthcare system is the emergency department, and geriatric emergency medicine sits at the crossroads,” explains Ula Y. Hwang, MD, MPH, professor of emergency medicine and population health at NYU Grossman School of Medicine. Dr. Hwang, a leader in her field, was recently appointed medical director of geriatric emergency medicine for the Ronald O. Perelman Department of Emergency Medicine. She notes that EDs are not favorable environments for older patients and are poorly adapted to care for their special needs. Dr. Hwang’s mandate is to establish a support network for NYU Langone’s geriatric emergency care and a related research infrastructure. “It’s largely a matter of devising quality and safety protocols that are tailored to this vulnerable population,” she says.

Fact: Patients 65 or Older Make Up 23 Percent of Trauma Admissions to Hospitals

Initiative: NYU Langone Hospital—Brooklyn Helps Seniors Bounce Back from Traumatic Injuries

Nearly 1,300 patients 65 or older are treated for trauma each year at NYU Langone Hospital—Brooklyn. In 2021, with funding from the Fan Fox & Leslie R. Samuels Foundation, the hospital established the Beyond Hospital Doors–Aging Wisely Grant Program to improve care for hospitalized older adults with traumatic injuries. “We looked at 427 older patients who had traumatic injuries, with the goals of returning them to their preinjury living, removing barriers to care, reducing reinjury, and screening for food insecurity,” says Lauren A. Parker, MD, the hospital’s medical director of geriatric medicine and palliative care. In 13 months, the program increased geriatric consults from 9 to 64 percent, follow-ups with primary care physicians from 16 to 80 percent, physical therapy consults from 63 to 72 percent, and nutritional consults from 28 to 71 percent. “This is a multidisciplinary model of care for NYU Langone and other institutions,” says Dr. Chodosh.

Fact: 35 Percent of People Age 65 or Older Need the Care of a Geriatrician

Initiative: An Ambulatory Clinic’s Holistic Approach to Older Adult Care

The demand for geriatricians will jump 50 percent by 2030, yet the number of these specialists is expected to decrease over the next decade. To combat the growing shortage, NYU Langone has established the Geriatric Ambulatory Consultative Clinic, based at NYU Langone Ambulatory Care Center East 41st Street. The clinic, established in 2023, focuses on comprehensive geriatric assessments and expands patient access to specialized services. The goal is to approach complex healthcare issues for older patients in a holistic manner, notes James M. Lai, MD, associate director of clinical services for the Division of Geriatric Medicine and Palliative Care. “Patients love it because they’re getting the kind of care they could never receive otherwise,” says Dr. Chodosh.

Fact: Of the More Than 700,000 Hospitalized Patients Who Experience a Fall Each Year, Most Are Older Adults

Initiative: Nurses at NYU Langone Hospital—Long Island Established Protocols for Reducing Patient Falls

Nearly 40 percent of hospital patients nationwide are over age 65, and falls are among the biggest threats to their safety. Fall prevention was the special focus of a recent year-long training program at NYU Langone Hospital—Long Island. Five nurses—Vincenza Coughlin, MS, RN; Gwenn Brown-Tammaro, BSN, RN; Heidi Pierluissi, MSOL, RN; Waitline Williams, PhD, RN; and Woodlyne Pierre-Lallemand, MSN, RN—participated in the Nurses Improving Care for Healthsystem Elders (NICHE) Leadership Training Program, a national program of NYU Rory Meyers College of Nursing. After new protocols were implemented on a pilot unit, falls among older adults decreased by 50 percent from November 2022 to December 2023. “The training enabled quality improvement through evidence-based care,” says Pierre-Lallemand. Every NYU Langone hospital is now part of the NICHE network.

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