Sustainability of a proactive geriatric trauma consultation service

Thanh, Nguyen X.; Chuck, Anderson W.; Wasylak, Tracy; Lawrence, Jeannette; Faris, Peter; Ljungqvist, Olle; Nelson, Gregg; Gramlich, Leah M.; Wong, Camilla L; Al Atia, Raghda; McFarlan, Amanda; Lee, Holly Y; Valiaveettil, Christina; Haas, Barbara
December 2016
Canadian Journal of Surgery;Dec2016, Vol. 59 Issue 6, p415
Academic Journal
journal article
Background: Proactive geriatric trauma consultation service (GTCS) models have been associated with better delivery of geriatric care and functional outcomes. Whether such collaborative models can be improved and sustained remains uncertain. We describe the sustainability and process improvements of an inpatient GTCS.Methods: We assessed workflow using interviews and surveys to identify opportunities to optimize the referral process for the GTCS. Sustainability of the service was assessed via a prospective case series (July 2012-December 2013). Study data were derived from a review of the medical record and trauma registry database. Metrics to determine sustainability included volume of cases, staffing levels, rate of adherence to recommendations, geriatric-specific clinical outcomes, trauma quality indicators, consultation requests and discharge destination.Results: Through process changes, we were able to ensure every eligible patient was referred for a comprehensive geriatric assessment. Compared with the implementation phase, volume of assessments increased and recommendation adherence rates were maintained. Delirium and/or dementia were the most common geriatric issue addressed. The rate of adherence to recommendations made by the GTCS team was 88.2%. Only 1.4% of patients were discharged to a nursing home.Conclusion: Workflow assessment is a useful means to optimize the referral process for comprehensive geriatric assessment. Sustainability of a GTCS was shown by volume, staffing and recommendation adherence.


Related Articles

  • Early feeding in colorectal surgery patients: safe and cost effective. Jochum, Sarah B.; Ritz, Ethan M.; Bhama, Anuradha R.; Hayden, Dana M.; Saclarides, Theodore J.; Favuzza, Joanne // International Journal of Colorectal Disease;Mar2020, Vol. 35 Issue 3, p465 

    Purpose: Enhanced recovery after surgery (ERAS) pathways has demonstrated improved outcomes in colorectal surgery. An important component of ERAS is early oral intake. The aim of this study is to determine the impact of early oral intake in patients following colorectal surgery. Methods: A...

  • Determinants of Costs and the Length of Stay in Acute Coronary Syndromes: A Real Life Analysis of More Than 10 000 Patients. Matthias Bramkamp; Dragana Radovanovic; Paul Erne; Thomas Szucs // Cardiovascular Drugs & Therapy;Oct2007, Vol. 21 Issue 5, p389 

    Abstract Aims  The aim of this study was to investigate inpatient costs of acute coronary syndromes (ACS) in Switzerland and to assess the main cost drivers associated with this disease. Methods and Results  We used the national multicenter registry AMIS (acute...

  • Frequency with which surgeons undertake pancreaticoduodenectomy continues to determine length of stay, hospital charges, and in-hospital mortality. Rosemurgy, Alexander; Cowgill, Sarah; Coe, Brian; Thomas, Ashley; Al-Saadi, Sam; Goldin, Steven; Zervos, Emmanuel // Journal of Gastrointestinal Surgery;Mar2008, Vol. 12 Issue 3, p442 

    Introduction: This study was undertaken to determine changes in the frequency of, volume of, and outcomes after pancreaticoduodenectomy 6 years after a study denoted that, in Florida, the frequency and volume of pancreaticoduodenectomy impacted outcome.Methods: Using...

  • Cost of care for dementia.  // Australian Nursing Journal;Apr2013, Vol. 20 Issue 9, p13 

    The article discusses a report titled "Dementia Care in Hospitals: Costs and Strategies" from the Australian Institute of Health and Welfare which found that people with dementia stay longer in new South Wales hospitals and have higher associated costs of care than patients without dementia.

  • Invasive mycoses linked with considerably higher costs.  // PharmacoEconomics & Outcomes News;12/12/2009, Issue 593, p8 

    The article discusses research on the link between invasive mycoses and health care costs. It references the study "Mortality, Length of Hospitalization, and Costs Associated With Invasive Fungal Infections in High-Risk Patients," by J. Menzin and colleagues, published in the October 2009 issue...

  • CVC-related bloodstream infections costly.  // PharmacoEconomics & Outcomes News;8/24/2013, Issue 685, p7 

    The article discusses the single-centre matched prospective cohort study conducted by German researchers which unveils the association of nosocomial central venous catheter-associated bloodstream infections (CVC BSI) with high medical care costs and prolonged hospitalization of patients.

  • Infection Control. Rowe, Molly // HealthLeaders Magazine;Nov2007, Vol. 10 Issue 11, p50 

    The author reflects on the increasing number of people who die from hospital-acquired infections (HAIs) in the U.S. She argues that HAIs are frequently left to departments like infection control and patient safety to address. She cites that reports have estimated that HAIs prolong hospital stays...

  • Medicare Short-Stay Hospital Utilization Trends: CYs 1972-93.  // Health Care Financing Review;Summer95 Supplement, Vol. 16, p52 

    The article explains statistical information on Medicare short-stay hospital utilization trends in the U.S. from 1972 to 1993. From 1972-83, the annual total days of care (TDOC) rate for Medicare beneficiaries increased slightly overall, from 3,656 per 1,000 enrollees to 3,786. The combination...

  • Prevention of postoperative pulmonary complications through intensive preoperative respiratory rehabilitation in patients with esophageal cancer. Inoue, J.; Ono, R.; Makiura, D.; Kashiwa-Motoyama, M.; Miura, Y.; Usami, M.; Nakamura, T.; Imanishi, T.; Kuroda, D. // Diseases of the Esophagus;Jan2013, Vol. 26 Issue 1, p68 

    Postoperative pulmonary complications (PPCs) after esophagectomy have been reported to occur in 15.9-30% of patients and lead to increased postoperative morbidity and mortality, prolonged duration of hospital stay, and additional medical costs. The purpose of this retrospective cohort study was...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics