GEDC’s Spotlight Series shares the great work that member organizations are doing in the field of geriatric emergency medicine.
Through the pursuit of GEDA accreditation, implementation of meaningful QI initiatives, and provision of educational resources for clinicians, health systems that take advantage of GEDC membership are setting the standard for outstanding geriatric emergency medicine.
Located in Glen Cove, New York, Glen Cove Hospital is part of Northwell Health. As the first emergency department in New York State to achieve and sustain Level 1 GEDA accreditation, the community hospital has become a leader in delivering exceptional, values-aligned care to older adults. Glen Cove has received numerous national honors, including ACEP’s 2024 Geriatric Emergency Department Patient Experience Award.
Nearly 70% of the hospital’s admissions are for older adult patients, and the emergency department has built a model grounded in safety, compassion and reliability. For Glen Cove, age-friendly care is a hospital-wide mission, and clinicians from nursing, physicians, pharmacy, social work, therapy services, palliative care, EMS partners and the Caregiver Center collaborate to provide comprehensive care.
“Glen Cove Hospital is deeply committed to delivering care that preserves dignity, protects independence, and aligns with What Matters Most from the moment patients arrive,” said Mityanand Ramnarine, MD, chairperson for emergency medicine at Glen Cove Hospital.
The hospital’s commitment to age-friendly care began as the emergency medicine team recognized the evolving needs of their community, Ramnarine said. Because the hospital serves a population that largely consists of older adult patients, the team completed a comprehensive redesign of its care approach to address their complex medical, cognitive and functional challenges.
The redesign, which began five years ago, prompted the ED team to examine data and community trends, which suggested that a traditional ED care model was not sufficient to meet the needs of this complex patient population. They relied on the Age-Friendly Health Systems 4Ms framework and embedded evidence-based geriatric practices into every aspect of care.
“This wasn’t merely an initiative,” Ramnarine said. “It became part of our identity as we restructured workflows, secured leadership support, built robust training infrastructure, and developed high‑reliability systems that sustain Level 1 accreditation.”
The 4Ms framework provides the foundation for Glen Cove’s emergency department environment. Through the ED’s What Matters Most program, goals-of-care conversations are completed for almost 70 percent of older adult patients.
Within this model, the roles of nurses and nurse leaders have evolved from a generalist approach to a highly specialized, proactive approach to age-friendly patient care. Nurses conduct comprehensive geriatric assessments that include vital screenings for cognition, functional status, polypharmacy and social support. They serve as patient advocates and care coordinators, delivering tailored interventions to prevent common geriatric syndromes like delirium and falls. Nurse leaders help develop and accredit GED programs and drive QI initiatives.
“This evolution was largely driven by the heightened recognition of older adults’ unique vulnerabilities, shifting care from merely reacting to symptoms to a dedicated, evidence-based strategy focused on optimizing outcomes and preserving independence for this population,” said Karen McKinney, MSN, RN, CEN, NE-BC, director of patient care at Glen Cove Hospital.
Glen Cove boasts a medication safety program, with comprehensive medication reconciliation that comprises more than 1,000 reviews annually and more than 400 pharmacist‑driven interventions accepted at a rate above 97 percent. Additionally, the ED has implemented successful QI initiatives in mentation screening, mobility workflows and age-friendly patient throughput.
“These QI initiatives collectively demonstrate that reliable, values-aligned care is both measurable and sustainable,” Ramnarine said. “By embedding the 4Ms: What Matters Most, Medication, Mentation, and Mobility into every encounter, we ensure that care is tailored, proactive, and anchored in patient values. Our high‑reliability model reduces length of stay, strengthens care transitions, prevents falls, meaningfully improves patient experience, and protects independence. It also preserves the dignity of older adults by ensuring that their goals guide clinical decisions.”
Along the way, Glen Cove has shared its successes and insights with GEDC’s worldwide network, Ramarine said. This shared commitment to improving emergency care for older adults has reinforced the significance of Glen Cove’s local efforts.
“Older adults represent the heart of our community, and many first encounter the healthcare system through the emergency department,” Ramnarine said. “We view it as our responsibility and privilege to ensure that experience is compassionate, safe, inclusive, and aligned with What Matters Most.”