Design and Evaluation of a Hospital-Based Educational Event on Fracture Care for Older Adult. (1st April 2021)

• Record Type: Journal Article
• Authors: Gosch, Markus; Kammerlander, Christian; Fantin, Emilio; Jensen, Thomas Giver; Salazar, Ana Milena López; Olarte, Carlos; Bavatonavarech, Suthorn; Medina, Claudia; Link, Bjoern-Christian; Cunningham, Michael
• Is Part Of: Geriatric orthopaedic surgery & rehabilitation. Volume 12(2021)
• Publication Date: 2021-04-01
• Subjects: fragility fractures -- geriatric trauma -- systems of care -- interprofessional education -- performance improvement -- hospital-based education; Older people -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; Geriatrics -- Rehabilitation -- Periodicals; 617.97
• DOI: 10.1177/21514593211003857
• Languages: English
• ISSNs: 2151-4585

Abstract

Introduction: Surgeons, internal medicine physicians, nurses, and other members of the healthcare team managing older adults with a fracture all have barriers to attending educational courses, including time away from practice and cost. Our planning group decided to create and evaluate a hospital-based educational event to address, meet, and improve the care of older adults with a fracture. Materials and Methods: A committee of surgeons and geriatricians defined 3 learning objectives to improve knowledge and attitudes in co-managed care. They designed a 1-day educational event consisting of a departmental visit, a review of cases, a planning session to identify gaps and plan changes, and presentations on selected topics. Thirteen hospitals worldwide completed an 8-question online application form, and 7 sites were selected for delivery over 3 years in Denmark, Colombia, Thailand, Paraguay, Switzerland, and the Dominican Republic. Results: Each event was conducted by 1 or more visiting surgeons and geriatricians, and the local team leaders. The most common challenges reported in the applications were preoperative assessment or optimization, delayed surgery, lack of protocols, access to a geriatrician, teamwork, and specific aspects of perioperative and postoperative care. In each department, 4 or 5 goals and targets for implementation were agreed. The presentations section was customized and attended by 20 to 50 team members. Discussion: Topics selected by a majority of departments were principles of co-managed care (7), preoperative optimization (7), and management of delirium (4). Follow up was conducted after 3 and 12 months to review the degree of achievement of each planned change and to identify any barriers to complete implementation. Conclusions: Hospital-based events with visiting and local faculty were effective to engage a broader audience that might not attend external courses. A performance improvement component with goal setting and follow up was acceptable to all host departments.