Multidisciplinary quality improvement programme for older patients admitted to a vascular surgery ward.

Internal Medicine Journal
Alison M MudgeMichael C Reade

Abstract

Older vascular surgical patients are at high risk of hospital-associated complications and prolonged stays. To implement a multidisciplinary co-management model for older vascular patients and evaluate impact on length of stay (LOS), delirium incidence, functional decline, medical complications and discharge destination. Prospective pre-post evaluation of a quality improvement intervention, enrolling pre-intervention (August 2012-January 2013) and post-intervention cohort (September 2013-March 2014). Participants were consenting patients aged 65 years and over admitted to the vascular surgical ward of a metropolitan teaching hospital for at least 3 days. Intervention was physician-led co-management plus a multidisciplinary improvement programme targeting delirium and functional decline. Primary outcomes were LOS, delirium and functional decline. Secondary outcomes were medical complications and discharge destination. Process measures included documented consultation patterns. Administrative data were also compared for all patients aged 65 and older for 12 months pre- and post-intervention. We enrolled 112 participants pre-intervention and 123 participants post-intervention. LOS was reduced post-intervention (geometric mean 7.6 ...Continue Reading

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May 31, 2016·Annals of Vascular Surgery·Prudence J McRaeAlison M Mudge
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Apr 27, 2017·Age and Ageing·Bastiaan Van GrootvenMieke Deschodt

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Citations

Oct 2, 2020·ANZ Journal of Surgery·Aisling M FleuryAlison M Mudge
Jan 21, 2021·BMC Geriatrics·Janani ThillainadesanVasi Naganathan
May 18, 2020·Journal of the American Medical Directors Association·Janani ThillainadesanVasi Naganathan

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