Postacute Management of Older Adults Suffering an Osteoporotic Hip Fracture: A Consensus Statement From the International Geriatric Fracture Society

Reyes, Bernardo; Mendelson, Daniel A.; Mujahid, Nadia; Mears, Simon C.; Gleason, Lauren J.; Mangione, Kathleen K; Nana, Arvind; Mijares, Maria C; Ouslander, Joseph G.

doi:10.1177/2151459320935100

Cited by 16 publications

(16 citation statements)

References 152 publications

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“…Many initiatives have been created in order to improve outcomes and reduce costs in an attempt to alleviate this overall burden of health care systems. The implementation of the orthogeriatric co-management model of care, integrated in specific functional units, has been a vital tool to improve outcomes [ 150 ].…”

Section: Costsmentioning

confidence: 99%

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Tarazona-Santabalbina

Ojeda-Thies

Rodríguez

et al. 2021

IJERPH

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Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Quality of care in orthogeriatric co-management units has increased, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

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Section: Costsmentioning

confidence: 99%

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Tarazona-Santabalbina

Ojeda-Thies

Rodríguez

et al. 2021

IJERPH

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show abstract

Section: Costsmentioning

confidence: 99%

Orthogeriatric Care: Reviewing Improvements in Outcomes

Tarazona-Santabalbina¹,

Ojeda-Thies²,

Rodríguez³

et al. 2021

Preprint

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Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Orthogeriatric co-management units have increased quality of care, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

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“…[6][7][8] The American Geriatrics Society (AGS) and the International Geriatric Fracture Society (IGFS) have identified the best available evidence for post-acute care settings to improve the outcomes of geriatric hip fracture patients, as well as minimize complications. 9 In addition, many guidelines recommend all patients with hip fracture receive active rehabilitation following their acute care stay with rehabilitation beginning no later than 6 days following surgery. 1,[10][11][12] Nonetheless, geriatric hip fracture patients often experience gaps in care including variability in the timing and the choice of the appropriate setting for rehabilitation following hip fracture surgery.…”

Section: Introductionmentioning

confidence: 99%

Barriers and Enablers to Early Identification, Referral and Access to Geriatric Rehabilitation Post-Hip Fracture: A Theory-Based Descriptive Qualitative Study

Backman

Harley

Papp

et al. 2022

Geriatr Orthop Surg Rehabil

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Background Geriatric hip fracture patients often experience gaps in care including variability in the timing and the choice of an appropriate setting for rehabilitation following hip fracture surgery. Many guidelines recommend standardized processes, including timely access of no later than day 6 to rehabilitation services. A pathway for early identification, referral and access to geriatric rehabilitation post-hip fracture was created to facilitate the implementation. The study aimed to describe the barriers and enablers prior to the implementation of this pathway. Methods We conducted a qualitative descriptive study consisting of semi-structured interviews with geriatric hip fracture patients (n = 8), caregivers (n = 1), administrators (n = 12) and clinicians (n = 17) in 2 orthopaedics units and a geriatric rehabilitation service. Responses were analysed using a systematic approach, and overarching themes describing the barriers and enablers were identified. Results The clinicians’ and administrators’ top barriers to implementation of the pathway were competing demands (n = 24); lack of bed availability, community resources and funding (n = 19); and the need for extended hours and increased staff (n = 16). The top 3 enablers were clear communication with patients (n = 27), awareness of the benefits of geriatric rehabilitation (n = 24) and the need for education and resources to properly use the pathway (n = 15). Common barriers among patients and caregivers included lack of care coordination, overcoming some of their own specific challenges during their transition, gaps in the information they received before discharge, not knowing what questions to ask and lack of resources. Despite these barriers, patients were generally pleased with their transition from the hospital to geriatric rehabilitation. Conclusion We identified and described key barriers and enablers to early identification, referral and access to geriatric rehabilitation post-hip fracture. These influencing factors provide a basis for the development of a standardized pathway aimed at improving access to rehabilitative care for geriatric hip fracture patients.

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Postacute Management of Older Adults Suffering an Osteoporotic Hip Fracture: A Consensus Statement From the International Geriatric Fracture Society

Cited by 16 publications

References 152 publications

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Orthogeriatric Care: Reviewing Improvements in Outcomes

Barriers and Enablers to Early Identification, Referral and Access to Geriatric Rehabilitation Post-Hip Fracture: A Theory-Based Descriptive Qualitative Study

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