Chi-Mei integrated Geriatric Emergency Team (CiGET)

The aging rate of Taiwan’s population ranks amongst the highest in the world. Since 2015, 12% of Taiwan’s population is over the age of 65, and is estimated to continue to increase to 20% by 2025, making our country a super-aged society. Moreover, elderly people require more medical attention than any other demographic. According to our National Health Insurance Administration, senior citizens account for 33% of healthcare-related spending, and is expected to increase to half of all national healthcare-related spending by 2025. Our healthcare system will need to face and embrace the challenges and rising expenditure of our elderly — compound and complex illnesses, disease recurrences, incomplete treatments, as well as psychological and economical complications.

The emergency department operates 24 hours a day all year round and thus has become the first choice to answering the elderly patients’ medical needs. Furthermore, emergency department treatments very much influence the disposition, prognosis, expenditure, and ongoing care of each patient, since the ER is a hub liaising between the outpatient department, the admission ward, home care, and care centers. The special care needs of older adults unfortunately are not aligned with the priorities of how ER physical space is designed and how ER care is rendered. Inadequate geriatric care knowledge, insufficient geriatric care resources and an unsystematic approach to elderly care often result in the readmission of these older patients, leading to a vicious cycle of health services overuse by these patients.

Geriatric Emergency Department Interventions (GEDIs) have begun to develop in countries such as the United States and Great Britain, but Taiwan hospitals have yet to establish similar programs. With the support of Chi Mei Medical Center’s Superintendent Chung-Ching Chio and Medical Deputy Superintendent Hung-Jung Lin and continuing our goal of becoming “the most reliable healthcare system”, ER Director Chien-Chin Hsu formed the Chi-Mei integrated Geriatric Emergency Team (CiGET) employing professionals from many fields by incorporating the nursing department, the geriatric department, the holistic care department, the palliative care center, the department of social services, the department of nutritional services, and the department of physical medicine and rehabilitation. We hope to become a pioneer for Taiwan hospitals in providing quality emergency care for older adults.

We believe that helping the elderly is helping ourselves; working for the elderly is working for a better future for all!

Specialist Training in Geriatric Emergency Medicine at the Department of Emergency Medicine of the Chi-Mei Medical Center

Objectives

This training program aims to bring together the Department of Geriatric Medicine and the Department of Emergency Medicine at the Chi-Mei Medical Center to cultivate Medical Emergency Specialists through:

(1) Coss-disciplinary team training, which fosters the ability to comprehensively manage complex, inter-disciplinary dilemmas of geriatric emergency medicine.
(2) The further development of geriatric medical ability through obtaining joint licensure for geriatric and hospice / palliative care, or specializing in hospice / palliative medicine.
(3) Preparing for future research and teaching in the area of geriatric medicine.

Methods of Implementation

Participating physicians must be licensed in emergency medicine, and be approved by the Senior Emergency Medical Practitioners Review Panel for this one-year program. During the training period, the physician is required to not only receive specialty training in Geriatric medicine, but also participate in teaching, research, and quality improvement efforts in the field. They are simultaneously required to receive training in hospice / palliative medicine, and eventually obtaining joint licensure for geriatric and hospice / palliative care, or licensure in hospice / palliative medicine.

Emergency Medicine Faculty

Advising Committee for Specialist Training in Geriatric Medicine

(This is in accordance with regulations of the Chi-Mei Medical Center Specialist Training Program in Geriatric Medicine, and the Department of Geriatric Medicine.)

Assessment

Participating physicians are required to complete the required core training courses in Geriatric medicine, and be approved by the Committee of Attending Geriatric Physicians in order for their participation in this specialty training program to be complete. (This is in accordance with regulations of the Chi-Mei Medical Center Specialist Training Program in Geriatric Medicine.)  After program completion, participating physicians are awarded a certification for specialty training in Geriatric Emergency Medicine after being approved by senior faculty members specializing in Geriatric Emergency Medicine.