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

Ruth de Las Casas*, Catherine Meilak, Anna Whittle, Judith Partridge, Jacek Adamek, Euan Sadler, Nick Sevdalis, Jugdeep Dhesi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)E608-E614
JournalClinical Medicine, Journal of the Royal College of Physicians of London
Volume21
Issue number6
DOIs
Publication statusPublished - Nov 2021

Keywords

  • Comprehensive geriatric assessment
  • Frailty
  • Implementation science
  • Perioperative medicine for older people undergoing surgery
  • POPS
  • Quality improvement
  • Surgery

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