Presentation Details
| Impact of Perioperative Geriatric service for inpatient Upper GI, Hepatobilliary and Colorectal surgery unit demonstrating improved outcomes. Afsana habib1, Brian Murphy2, imroj Qazi3. 1Consultant Geriatrician, Perth, Australia.2Registrar, Perth, Australia.3Senior data analyst, Perth, Australia |
Abstract
BACKGROUND: The numbers of Older adult patients having Upper GI/hepatobilliary and Colorectal surgeries are rising. Majority of these surgeries are due to malignancy and mangement is complex in this age group due to frailty and comorbidities. Geriatric in reach service called FOCUS (Frail and Older Adult care of Colorectal/Upper GI surgery) was implemented in September'24 to provide Comprehensive Geriatric Care providing Pre-operative optimisation, post operative care, rehabilitation and discharge planning.
METHODS: Prospective cohort study where Comprehensive Geriatric Assessment (CGA) was applied proactively to all 70 years old perioperatively and anyone above 65 requested from Surgical team from Feb’25 till now. FOCUS review was limited to consultation only service from September’24 to January’25. From Feb-July'25, this service provided 3 consultant ward rounds weekly with RMO. Since August, Senior registrar was included in the team to review patients daily on the weekdays.The outcomes included Length of stay, readmission in 30 days, hospital acquired complications and discharge destination which were compared with the data from the previous year without FOCUS service.
RESULTS: This study showed similar length of stay of 12 days on average, reduction of readmission rate from 21% to 12% and overall reduction of the numbers hospital acquired complication rate since proactive CGA were applied comparing to the baseline data. FOCUS discharge destination included on average 80 percent home in comparison to average 74 percent prior to the intervention.
CONCLUSIONS: This study has demonstrated effectiveness of proactive Geriatric assessment in improving quality of patient's hospital admission by reducing hospital acquired complication, readmission rate and discharging home. Further study in place to perform cost consequence analysis to compare effectiveness of CGA in Perioperative care of Upper GI/Colorectal surgery unit.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
METHODS: Prospective cohort study where Comprehensive Geriatric Assessment (CGA) was applied proactively to all 70 years old perioperatively and anyone above 65 requested from Surgical team from Feb’25 till now. FOCUS review was limited to consultation only service from September’24 to January’25. From Feb-July'25, this service provided 3 consultant ward rounds weekly with RMO. Since August, Senior registrar was included in the team to review patients daily on the weekdays.The outcomes included Length of stay, readmission in 30 days, hospital acquired complications and discharge destination which were compared with the data from the previous year without FOCUS service.
RESULTS: This study showed similar length of stay of 12 days on average, reduction of readmission rate from 21% to 12% and overall reduction of the numbers hospital acquired complication rate since proactive CGA were applied comparing to the baseline data. FOCUS discharge destination included on average 80 percent home in comparison to average 74 percent prior to the intervention.
CONCLUSIONS: This study has demonstrated effectiveness of proactive Geriatric assessment in improving quality of patient's hospital admission by reducing hospital acquired complication, readmission rate and discharging home. Further study in place to perform cost consequence analysis to compare effectiveness of CGA in Perioperative care of Upper GI/Colorectal surgery unit.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
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