design lab melanie mccomsey geriatric thornton hospital

Improving Senior Care Through Geriatric Emergency Department Research

Improving Senior Care Through Geriatric Emergency Department Research

Improving Senior Care Through Geriatric Emergency Department Research

Geriatric emergency departments  (GEDs) are specialized facilities designed to cater to the medical needs of the elderly. They are a relatively new trend in hospitals, yet little research has been done on their progress and evolution.

In 2016, UC San Diego’s Thornton Hospital received an $11.8 million grant from the Gary and Mary West Foundation to create the San Diego region’s first geriatric emergency room and as of 2017 is now operational. “When we started this project, the geriatric emergency room at UCSD’s Thornton Hospital was already being planned. We wanted to look at the best practices in other existing GED programs that are part of the Geriatric Emergency Department Collaborative. From there we gathered ideas that could be implemented in Thornton hospital,” says Melanie McComsey, a design anthropologist and postdoctoral researcher at the UC San Diego Design Lab. “We needed to determine what different programs were doing, how those programs evolved, and what they learned.”

A joint project between UCSD Health, UCSD Design Lab, and the non-profit West Health Institute, McComsey and her West Health colleague, James Howard, visited four different GED departments around the United States. The pair performed observational ethnographic research at each of the sites, shadowing providers and getting a sense of their job and workflow. Through this, they were able to gain a better understanding of how each GED operated.

One of the most interesting findings that emerged from the project was that each program had developed locally-specific innovations.

“A lot of the most interesting innovations were closely tailored to that specific program and wouldn’t make sense to implement at Thornton,” says McComsey. “We used ‘‘lead user design’ to look at local providers, and in some cases even local patients. Those patients had noticed a need or an opportunity and had done something about it and the idea spread across the hospital.”

An example of an interesting local innovation was a nurse who created his own follow-up program upon noticing that a number of the patients returned to the ER for reasons related to their previous condition.

“What was really cool about this approach was the nurse was able to get permission from the hospital to follow up with patients at home. He would ride his commuter bike stocked with a first aid kit to these patients’ houses to check-in and follow-up after their ER visit,” says McComsey. “It was so successful that the hospital actually institutionalized these follow-up visits. The hospital purchased a van, got the right insurance and approvals, and sent him back to school to become a nurse practitioner which gave him the skill-set to improve patient care.”

Aside from best practices, another goal of the project was to gain insight on the benefits of GEDs and determine whether they would be an effective way to aid the aging population. The number of people over the age of 65 is set to double within the next 50 years, and it’s important to study this demographic and establish programs to allow them to live comfortably in our society.

Geriatric emergency departments  (GEDs) are specialized facilities designed to cater to the medical needs of the elderly. They are a relatively new trend in hospitals, yet little research has been done on their progress and evolution.

In 2016, UC San Diego’s Thornton Hospital received an $11.8 million grant from the Gary and Mary West Foundation to create the San Diego region’s first geriatric emergency room and as of 2017 is now operational. “When we started this project, the geriatric emergency room at UCSD’s Thornton Hospital was already being planned. We wanted to look at the best practices in other existing GED programs that are part of the Geriatric Emergency Department Collaborative. From there we gathered ideas that could be implemented in Thornton hospital,” says Melanie McComsey, a design anthropologist and postdoctoral researcher at the UC San Diego Design Lab. “We needed to determine what different programs were doing, how those programs evolved, and what they learned.”

A joint project between UCSD Health, UCSD Design Lab, and the non-profit West Health Institute, McComsey and her West Health colleague, James Howard, visited four different GED departments around the United States. The pair performed observational ethnographic research at each of the sites, shadowing providers and getting a sense of their job and workflow. Through this, they were able to gain a better understanding of how each GED operated.

One of the most interesting findings that emerged from the project was that each program had developed locally-specific innovations.

“A lot of the most interesting innovations were closely tailored to that specific program and wouldn’t make sense to implement at Thornton,” says McComsey. “We used ‘‘lead user design’ to look at local providers, and in some cases even local patients. Those patients had noticed a need or an opportunity and had done something about it and the idea spread across the hospital.”

An example of an interesting local innovation was a nurse who created his own follow-up program upon noticing that a number of the patients returned to the ER for reasons related to their previous condition.

“What was really cool about this approach was the nurse was able to get permission from the hospital to follow up with patients at home. He would ride his commuter bike stocked with a first aid kit to these patients’ houses to check-in and follow-up after their ER visit,” says McComsey. “It was so successful that the hospital actually institutionalized these follow-up visits. The hospital purchased a van, got the right insurance and approvals, and sent him back to school to become a nurse practitioner which gave him the skill-set to improve patient care.”

Aside from best practices, another goal of the project was to gain insight on the benefits of GEDs and determine whether they would be an effective way to aid the aging population. The number of people over the age of 65 is set to double within the next 50 years, and it’s important to study this demographic and establish programs to allow them to live comfortably in our society.

Geriatric emergency departments  (GEDs) are specialized facilities designed to cater to the medical needs of the elderly. They are a relatively new trend in hospitals, yet little research has been done on their progress and evolution.

In 2016, UC San Diego’s Thornton Hospital received an $11.8 million grant from the Gary and Mary West Foundation to create the San Diego region’s first geriatric emergency room and as of 2017 is now operational. “When we started this project, the geriatric emergency room at UCSD’s Thornton Hospital was already being planned. We wanted to look at the best practices in other existing GED programs that are part of the Geriatric Emergency Department Collaborative. From there we gathered ideas that could be implemented in Thornton hospital,” says Melanie McComsey, a design anthropologist and postdoctoral researcher at the UC San Diego Design Lab. “We needed to determine what different programs were doing, how those programs evolved, and what they learned.”

A joint project between UCSD Health, UCSD Design Lab, and the non-profit West Health Institute, McComsey and her West Health colleague, James Howard, visited four different GED departments around the United States. The pair performed observational ethnographic research at each of the sites, shadowing providers and getting a sense of their job and workflow. Through this, they were able to gain a better understanding of how each GED operated.

One of the most interesting findings that emerged from the project was that each program had developed locally-specific innovations.

“A lot of the most interesting innovations were closely tailored to that specific program and wouldn’t make sense to implement at Thornton,” says McComsey. “We used ‘‘lead user design’ to look at local providers, and in some cases even local patients. Those patients had noticed a need or an opportunity and had done something about it and the idea spread across the hospital.”

An example of an interesting local innovation was a nurse who created his own follow-up program upon noticing that a number of the patients returned to the ER for reasons related to their previous condition.

“What was really cool about this approach was the nurse was able to get permission from the hospital to follow up with patients at home. He would ride his commuter bike stocked with a first aid kit to these patients’ houses to check-in and follow-up after their ER visit,” says McComsey. “It was so successful that the hospital actually institutionalized these follow-up visits. The hospital purchased a van, got the right insurance and approvals, and sent him back to school to become a nurse practitioner which gave him the skill-set to improve patient care.”

Aside from best practices, another goal of the project was to gain insight on the benefits of GEDs and determine whether they would be an effective way to aid the aging population. The number of people over the age of 65 is set to double within the next 50 years, and it’s important to study this demographic and establish programs to allow them to live comfortably in our society.

Read Next

Design Lab Faculty

New Design Lab Faculty Working to Shape the Future of UC San Diego

As a global pioneer in design thinking, research, and invention, The Design Lab prides itself on recruiting the brightest and most innovative minds in the design field. Today, we would like to extend a warm welcome to brand new faculty members Elizabeth Eikey, Haijun Xia, and Edward Wang!

Elizabeth Eikey
From a first-generation undergraduate student at Penn State, then an inquisitive Best Buy employee and finally, to the Assistant Professor in the Department of Family Medicine and Public Health & The Design Lab at UCSD, Dr. Elizabeth Eikey has an illustrious career. Her research work at The Design Lab focuses on the intersection between technology, mental health, and equity, primarily studying the possible applications for technology in supporting mental health and well-being.

Haijun Xia
After receiving his PhD in Computer Science from University of Toronto, Xia made the move across countries to begin his time as a researcher at UC San Diego. ‘I wanted to work at The Design Lab and UC San Diego, because of the diversity of skill here,’ says the Professor, ‘We are all approaching the many challenging research questions from different angles, which is really important to develop comprehensive solutions.

Edward Wang
When Edward Wang was an undergraduate student at Harvey Mudd, he never expected himself to become a researcher, let alone becoming a professor. It was only after a Professor offered him the chance to help design a course she was planning about biosignal processing, that he began on this path. ‘As I was designing the class over summer, I had to read a bunch of papers,’ he says, ‘I couldn’t stop thinking about how cool all of it was. Especially when it branched out into computer science and how it could be involved in biosignal processes.’
Earth2 Project Challenges Vaccines

Earth2 Project Challenges Vaccines, 10 to 100, Ten Days to Vaccinate Everyone

"In collaboration with the University of New Mexico, the Earth2 project is helping to present a 10 day series of seminars on Vaccines and Vaccine Hesitancy, covering topics that range from vaccine-myths to Native American implications and special aspects having to do with other minority and LGBTQ communities, to hearing trusted voices." - David Brin, Author, Futurist, Public Speaker

"Solving the most complex societal programs involves a whole community approach. That's why I'm so excited about the Earth 2 Challenge to reach 100% vaccination which will make our society healthier and safer. But to succeed, we need everyone to participate." - Mai Nguyen, Design Lab Director, UC San Diego
How To Reduce Obesity Among Latino Children

How to Reduce Obesity among Latino Children, with Precision

UC San Diego and community collaborators receive $3 million grant to develop more community-centered, precision approaches to reducing adverse childhood events that lead to obesity, a nationwide problem

“Working with the Latino community, we want to create a family-based approach to improve individual and community resilience to stress and address the obesity epidemic,” said lead principal investigator Gary S. Firestein, MD, Distinguished Professor of Medicine and ACTRI director.

Blanca Meléndrez, director of the Center for Community Health at UC San Diego and a co-principal investigator on the study with Eric Hekler, PhD, Design Lab member, professor and interim associate dean for community partnerships in the Herbert Wertheim School of Public Health, said that beyond determining which methods best promote resiliency and reduce obesity among children, researchers and community collaborators will seek to create interventions that can be delivered to different families that match a family’s unique circumstances and needs.
Brian LeDuc

Brian Leduc on Learning Agility & Career Changers | Design Chats


Brian LeDuc, Design Lab Designer-In-Residence, talks about his work on creating resources for career changers.

Design Chats is a video series where we sit down with design practitioners to answer questions about how they utilize human-centered design.

View our Design Chats playlist on the Design Lab YouTube Channel
Don Norman

Design a Better World, with Don Norman

UX Cake kicks the season off with a fascinating conversation about changing the world with design, with Don Norman.

"There are really creative people in all these communities. And there aren’t enough experts to go around anyway. What we want to do is go around the world and find these people and facilitate, help them, empower them, give them expert knowledge and allow them to decide how to apply that to their problems." - Don Norman
Ucsd Extension Design Bootcamp

Design Lab and UCSD Extension Team Up for Design Bootcamp

This past July, San Diego high school students embarked on a five-day dive into anthropology and design as part of Design Bootcamp, a collaboration between the UC San Diego Design Lab and UC San Diego Extension.

The class first emerged from the demand for design workshops in San Diego coupled with UC San Diego’s interest in offering classes to pre-collegiate students. “This first Research Scholars ‘Design Bootcamp,’ if you will, is our first prototype,” says Michele Morris, Design Lab Associate Director. “The needs of the University, the expertise of the Design Lab, and the community platforms of UC San Diego’s Extension all came together seamlessly.”

Mayya Azarova, a Design Lab Anthropology PhD candidate, joined the team as the Bootcamp’s inaugural instructor.  Coupling her background in anthropology with design, the team customized an offering focused around ethnography and empathy-building.
Back To Top