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Project

Geriatrics and traumato co-managing fragility fractures: effectiveness and success of implementation in a single centre setting

Background: Osteoporosis is the most common musculoskeletal disease and predisposes to fractures, most common of hip, spine, proximal humerus, pelvis and wrist. These fragility fractures are associated with pain, disability, need for institutionalization and even death. The complex needs of the older fracture patient with multimorbidity, polypharmacy and geriatric syndromes require a holistic, multidisciplinary approach. This is the expertise of geriatricians and geriatric teams. At the moment there is little cooperation between geriatricians and surgeons in Belgium due to the current care organization with silo financing. Moreover, effects of geriatric consultation teams are quite limited as repeatedly observed in literature, due to their reactive nature and lack of implementation of advice given. Research and clinical focus has therefore shifted towards co-management models with shared responsibility and decision-making. The University Hospitals Leuven (UHL) have recently approved a quality-improvement project, which aims to implement a nurse-led geriatric-surgical co-management program, named G-COMAN. Goal: The overall aim of this study is to evaluate the effectiveness of geriatric-traumatology co-management and to examine which factors contribute to a (non) successful implementation of this co-management. Methods: Prospective, pre-post implementation study on the traumato ward of UHL. The usual care group will be treated by the regular trauma team and receive geriatric advise solely upon active request by the traumato team. The patients in the geriatric co-management intervention group will receive a comprehensive geriatric assessment by nurses trained in geriatric care. Impact: The results of this study are expected to generate important evidence on the effectiveness of a nurse-led geriatric co-management model and provide us insights in how this model can be firmly embedded into routine clinical practice in Belgium.

Date:4 Aug 2021 →  Today
Keywords:Orthogeriatrics, Co-management, Osteoporosis, Fragility fractures
Disciplines:Geriatrics
Project type:PhD project