Establishing a perioperative medicine for older people undergoing surgery service for general surgical patients at a district general hospital

TY - JOUR

T1 - Establishing a perioperative medicine for older people undergoing surgery service for general surgical patients at a district general hospital

AU - de Las Casas, Ruth

AU - Meilak, Catherine

AU - Whittle, Anna

AU - Partridge, Judith

AU - Adamek, Jacek

AU - Sadler, Euan

AU - Sevdalis, Nick

AU - Dhesi, Jugdeep

N1 - Funding Information: Within 18 months, a substantive perioperative service for older people was established at a DGH, funded by the surgical directorate. Key outcomes included reduction in length of stay and 30-day readmission and positive staff and patient experience. Publisher Copyright: © Royal College of Physicians 2021. All rights reserved.

PY - 2021/11

Y1 - 2021/11

N2 - Introduction There is growing recognition of the need for perioperative medicine services for older surgical patients. Comprehensive geriatric assessment and optimisation methodology has been successfully used to improve perioperative outcomes at tertiary centres. This paper describes translation of an established model of geriatrician-led perioperative care to a district general hospital (DGH) setting. Methods A mixed methods quality improvement programme was used and included stakeholder co-design, identification of core components, definition of mechanisms for change, and measurement of impact through qualitative and quantitative approaches. Results Within 18 months, a substantive perioperative service for older people was established at a DGH, funded by the surgical directorate. Key outcomes included reduction in length of stay and 30-day readmission and positive staff and patient experience. Discussion This study is in keeping with improvement science literature demonstrating the importance of a mixed-methods approach in translating an evidenced-based intervention into another setting, maintaining fidelity and replicating results.

AB - Introduction There is growing recognition of the need for perioperative medicine services for older surgical patients. Comprehensive geriatric assessment and optimisation methodology has been successfully used to improve perioperative outcomes at tertiary centres. This paper describes translation of an established model of geriatrician-led perioperative care to a district general hospital (DGH) setting. Methods A mixed methods quality improvement programme was used and included stakeholder co-design, identification of core components, definition of mechanisms for change, and measurement of impact through qualitative and quantitative approaches. Results Within 18 months, a substantive perioperative service for older people was established at a DGH, funded by the surgical directorate. Key outcomes included reduction in length of stay and 30-day readmission and positive staff and patient experience. Discussion This study is in keeping with improvement science literature demonstrating the importance of a mixed-methods approach in translating an evidenced-based intervention into another setting, maintaining fidelity and replicating results.

KW - Comprehensive geriatric assessment

KW - Frailty

KW - Implementation science

KW - Perioperative medicine for older people undergoing surgery

KW - POPS

KW - Quality improvement

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=85121740170&partnerID=8YFLogxK

U2 - 10.7861/clinmed.2021-0356

DO - 10.7861/clinmed.2021-0356

M3 - Article

AN - SCOPUS:85121740170

SN - 1470-2118

VL - 21

SP - E608-E614

JO - Clinical Medicine, Journal of the Royal College of Physicians of London

JF - Clinical Medicine, Journal of the Royal College of Physicians of London

IS - 6

ER -