New Hampshire - June 2020

Page 14 • New Hampshire Nursing News June, July, August 2020
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Allenstown, NH
Tiffany Hutchins
Atkinson, NH
Charlotte Dimaggio
Auburn, NH
Angela Diorio
Bedford, NH
Julia Duquette
Boscawen, NH
Brooke McLain
Bow, NH
Sally J. Jenkins
Brentwood, NH
Sarah Dinneen
Claremont, NH
Odalie Bernash
Concord, NH
Susan Bryant
Mary Elizabeth Cahan
Dorothy Michelle
DeLisa
Derry, NH
Dawn LaPorte
Stephanie Russo
Barbara Sullivan
Dover, NH
Jeanne Spurlin
Laura Willett
Elkins, NH
Shari Goldberg
Goffstown, NH
Julianne M. Ashton
Hampton, NH
Nicole Susan
Leibundgut
Hooksett, NH
Sabrina Bolianites
Hudson, NH
Elizabeth Duffy
Elizabeth Martell
Intervale, NH
Jennifer Leigh Grise
Keene, NH
Margo Helen Banks
Rachel Hough
Laconia, NH
Deborah E. Bossey
Lebanon, NH
Nadine Nicola Brown
Dayhna Pamela Marti
Ojeda
Janice E. Morton
Lee, NH
Suellen Olson Drake
Lisbon, NH
Sean Destephanis
Littleton, NH
Bailey Dammen
Manchester, NH
Melinda Daigle Bennet
Martha Derkach
Mirline Estiverne
Kathleen Fantozzi
Kathleen Bridget
Forbush
Jessica Gluek
Pamela Lee Gomes
Cindy T. Louxay
Jessica McCardell
Claude Mua
Kim Ozuna
Hannah Pirozzoli
Melissa Vitagliano
Merrimack, NH
Julie Brady
Nashua, NH
Tammi Boudreau
Mellony Cude
Alana Evans
Emily Madison
Lily Roselin Raja
New Boston, NH
Emma Angeline Pinard
New Hampton, NH
Jaimie N. Walton
Newton, NH
Tina Greenwood
Northfield, NH
Michele Ann Murphy
Taylor Thompson
Penacook, NH
Cynthia Bergeron
Peterborough, NH
Brittany Stokes
Plainfield, NH
Sunshyne June Rice
Plymouth, NH
Paula Michelle Hurvit
Moulton
Rindge, NH
Donna J. Babb
Salem, NH
Brittany Burke
Bethany A. Pelletier
Stratham, NH
Ericka J. McCarron
Sunapee, NH
Arlene M. Halsted
Thornton, NH
Kimberly Ann Thibault
Wolfeboro, NH
Dara St. Sauveur
Woodsville, NH
Dina Quinn
Nurse in Key Role in New Geriatric Program
Dartmouth-Hitchcock Medical
Center (DHMC), in partnership
with West Health of Lebanon,
has launched a three-year
effort to build a hub and spoke
model Geriatric Emergency
Department (GED) aimed at
keeping most geriatric patients
in their communities through
telemedicine. A key player
in the development of this
innovative approach to caring
for geriatric patients in northern
New Hampshire is Hilary
Hawkins, BSN, RN, Geriatric
Emergency Department
Manager at DHMC. Hawkins
is responsible for developing
Hilary Hawkins,
BSN, RN, Geriatric
Emergency
Department Manager
at DHMC.
care protocols and implementing screening tools to assess
the needs of the geriatric patient. “The idea behind [the
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GED] is DHMC (the hub) has many resources such as case
managers, social workers, pharmacists and geriatricians that
can help community hospitals (spokes) with the geriatric
population, to keep them in their community hospitals or
their homes,” states Hawkins. Research has demonstrated
that admitting geriatric patients can often lead to additional
risks versus maintain them in their home or community. Of
course, if these patients need to be at DHMC they will be
welcomed.
Hilary Hawkins, BSN, MBA, RN, CEN, CPEN, TNRN
always knew she wanted to be in health care. Her father
was a nursing home administrator and she spent time there
growing up. “I first started in healthcare in EMS and then
obtained my BSN. As a nurse, I have worked in the adult
intensive care unit, the emergency department, trauma
performance improvement and then running trauma
programs. Statics show that trauma in NH is predominantly
65 years and older which led me to work closely with
palliative care, hospice and ethics committees,” remarks
Hawkins. Hawkins is certified in Geriatric Emergency
Nursing Education (GENE), as designated by the Emergency
Nursing Association, the leading professional organization
for emergency nurses.
“We’re delighted to have Hilary’s insight, experience
and expertise so tightly woven into the development of
our GED,” says Karen Clements, RN, FACHE, D-H Chief
Nursing Officer. “This investment will have a lasting
positive impact on our patients and our communities,
and for that reason it’s absolutely imperative that we have
qualified nurses, like Hilary, so closely engage in what we’re
creating.”
GED nurses are aware of the nuances in care required
by geriatric patients, including the need for additional
assessments to detect underlying issues with mental
health, physical health or in need of additional resources.
“They work closely with care management to ensure that
the patient has the appropriate resources or equipment at
home and that they understand their discharge plans or
follow up,” notes Hawkins. GED nurses also ensure that the
patient is receiving the care that matters most to them. Most
often that care is at home.
The goal of the GED is to recognize those patients who will
benefit from inpatient care, and to effectively implement
outpatient care to those who do not require inpatient
resources. The GED utilizes additional staffing, equipment,
education, policies and procedures, follow-up care, and
performance improvement measures. When implemented
collectively, the GED hopes to see improvements in patient
care, customer service, and staff satisfaction. Improved
attention to the needs of this challenging population has
the opportunity to more effectively allocate health care
resources, optimize admission and readmission rates,
while simultaneously decreasing iatrogenic complications
and the resultant increased length-of-stay and decreased
reimbursement.
Developing the care protocols the GED will use has been a
multidisciplinary team approach based on evidence. These
disciplines include and are not limited to pharmacists,
nurses, physicians, care managers, social workers, physical
therapists, occupation therapists, as well as community
resources and experts in the area of aging. Additionally, the
team is developing a robust data analysis process that will
guide much of the work going forward and help to identify
quality measures and understand related outcomes.
“The Geriatric Team at DHMC is still working on
developing and refining their processes and the
application,” comments Hawkins. The spoke and hub
implementation has slowed down as resources are needed
to focus on COVID -19. The Geriatric Team continues to be
a presence in the ED during the pandemic and is live-time
providing support to our older families. The Geriatric Team
is also adding their collective experience to the Nursing
Home Collaborative which is meeting to discuss how
nursing facilities can maximize the use of their resources
in the best interest of all patients, and still protect their
residents who are some of our most vulnerable.