Hospital-Wide Comprehensive Geriatric Assessment: Service level toolkit to improving care

jiná publikace

Conroy, S., Martin, G., Kocman, D., Parker, S., Bardsley, M., Kennedy, S., Neuburger, J., Phelps, K., Regen, E., Roberts, H., Sherlaw, Ch., Smith, P. 2018. „Hospital-Wide Comprehensive Geriatric Assessment: Service level toolkit to improving care.“ British Geriatrics Society clinical guidelines. (clinical guidelines) Dostupné z: https://www.bgs.org.uk/resources/how-cga-introduction-to-the-service-level-toolkit.

Frail older people admitted for acute inpatient hospital care are at high risk of adverse events, long stays, readmission and long term care. Comprehensive Geriatric Assessment (CGA) improves outcomes for this group, particularly on specialised wards. However, there is uncertainty about how best to do this across the whole hospital.

The aim of this project was to provide high quality evidence on delivering hospital-wide Comprehensive Geriatric Assessment (CGA). The objectives were to:

Define CGA, its processes, outcomes and costs in the published literature
Identify the processes, outcomes and costs of CGA in existing hospital settings in the UK
Identify the characteristics of the recipients and beneficiaries of CGA in existing hospital settings in the UK
Develop tools which will assist in the implementation of hospital-wide CGA.

We used mixed methods including a mapping review, national survey, large data analysis, and qualitative methods, focusing upon people aged 65+ in acute hospital settings.

Comprehensive Geriatric Assessment remains the gold standard approach to improve a range of outcomes for older people in acute hospitals. Older people at risk can be identified using routine hospital data. Toolkits aimed at enhancing the delivery of CGA by non-specialists can be useful, but require prolonged geriatrician support and implementation phases.