Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines

Abstract Background The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality me...

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Bibliographic Details
Published in:The Journal of surgical research 2017-08, Vol.216, p.56-64
Main Authors: Southerland, Lauren T., MD, Gure, Tanya R., MD, Ruter, Daniel I., BS, Li, Michael M., BA, Evans, David C., MD, FACS
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Female
Geriatric Assessment - statistics & numerical data
Geriatric consultation
Geriatrics
Guideline Adherence - statistics & numerical data
Humans
Male
Outcome and Process Assessment (Health Care)
Practice Guidelines as Topic
Quality Improvement - statistics & numerical data
Quality Indicators, Health Care - statistics & numerical data
Quality measures
Retrospective Studies
Surgery
TQIP
Trauma
Trauma Centers - standards
Trauma Centers - statistics & numerical data
Wounds and Injuries - diagnosis
Wounds and Injuries - therapy
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Summary:Abstract Background The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. Methods This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation. Secondary analyses evaluated adherence by service: trauma service (Trauma) or a trauma service with early geriatric consultation (GeriTrauma). Results The average age of the 245 patients was 76.7 years, 47% were women, and mean Injury Severity Score was 9.5 (SD ±8.1). Implementation of the GeriTrauma collaborative increased geriatric consultation rates from 2% to 48% but had minimal effect on overall adherence to TQIP quality measures. A secondary analysis comparing those in the post implementation group who received geriatric consultation (n=94) to those who did not (n=103) demonstrated higher rates of delirium diagnosis (36.2% vs 14.6%, p
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2017.03.023