An Interdisciplinary Geriatric Consultation Service: A Controlled Trial

Abstract

The structure and function of a newly created interdisciplinary Geriatric Consultation Team (GCT) are described. The GCT was introduced on a single medical unit, where consultations were given to 46 consecutive patients aged 75 years and over. The GCT patients had, on the average, 5.5 illnesses and were receiving 3.7 medications. Anemia (50 per cent), were hypoalbuminemia (65 per cent), and elevated blood urea nitrogen (BUN) (58 per cent) were frequent. Functional assessment showed frequent dependence on others for assistance with ambulation (59 per cent), transfers (54 per cent), and dressing (52 per cent); cognitive impairment was found in 52 per cent and clinical depression in 11 per cent of the patients. In comparison with control units, the GCT increased use of physical therapy by 357 per cent, occupational therapy by 390 per cent, and speech therapy by 300 per cent without increasing length of stay. In comparison with control subjects, GCT patients had no decrease in hospital readmission rates (43 per cent) over 10.5 months of follow up. It was concluded that a GCT in an acute-care hospital promotes geriatrics, teaches interdisciplinary teamwork, improves awareness of functional problems of patients, and increases use of rehabilitative services, but does not decrease the high rate of readmission of hospitalized geriatric patients.

Effects of hospital-wide interventions to improve care for frail older inpatients: a systematic review

“…One21 of five studies (four GCT,11 19 21 22 26 one geriatric-based ward21) presenting data on rehospitalisation showed fewer readmissions per patient, at 6 months' follow-up.…”

Frailty in Older Adults: Evidence for a Phenotype

“…Numerous geriatric interventions have been developed to improve clinical outcomes for frail older adults (3)(4)(5)(6)(7). A major obstacle to the success of such interventions has been the absence of a standardized and valid method for screening of those who are truly frail so as to effectively target care (1,3).…”

Organization of rehabilitation services

“…89 In North America there is a tendency for geriatric teams to comprise only doctors, nurses, and social workers 90 -91 and to simply make written recommendations to the medical team managing the patient. 92 ' 93 Such teams may reduce lengths of hospital stay, but seldom produce any improvement in disability. 94 Seventeen controlled trials of geriatric medical services in North America were recently reviewed.…”