Research Abstract: Free Paper - Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

‘Demystifying’ POPS: Core elements of the perioperative medicine for older people undergoing surgery (POPS) service (#9)

Margot E Lodge 1 2 3 , Jugdeep Dhesi 4 5 , David JH Shipway 6 7 , Philip Braude 6 , Catherine Meilak 8 , Judith Partridge 4 5 , Nadine E Andrew 1 2 , Velandai Srikanth 1 2 9 , Darshini R Ayton 1 10 11 , Chris Moran 1 2 3 9 11
  1. National Centre for Healthy Ageing, Melbourne, Victoria, Australia
  2. Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
  3. Health of Older People, Alfred Health, Melbourne, Victoria, Australia
  4. Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
  5. King's College London, London, United Kingdom
  6. CLARITY (Collaborative Ageing Research) group, North Bristol NHS Trust, Bristol, United Kingdom
  7. University of Bristol, Bristol, United Kingdom
  8. East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom
  9. Peninsula Health, Frankston, Victoria, Australia
  10. Health and Social Care Unit, Monash University, Melbourne, Victoria, Australia
  11. School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

Aim: Perioperative medicine for older people undergoing surgery (POPS) services deliver a complex model of care that improves outcomes for older people contemplating and undergoing surgery. Complex models of care may be difficult to implement without understanding the elements that comprise the service delivering that model of care. One way of describing these elements is with a logic model, which can be used to aid implementation by visually depicting theoretical relationships between the elements of the service. This study aimed to understand the key core elements of the POPS service.

 

Methods: We performed a qualitative case study in the United Kingdom at three contextually different National Health Service (NHS) Trusts with POPS services of varying implementation maturity. We conducted semi-structured interviews of 56 clinicians and managers. The interviews were analysed using inductive and deductive methods.

 

Results: We developed a multiple-site logic model with themes that described the core elements of the POPS service across seven logic model domains. We found that the POPS service could be adapted to ‘fit’ local context and still achieve its desired outcomes if it remained true to the principles of comprehensive geriatric assessment and optimisation, and was delivered by staff with expert skills and attitudes.

 

Conclusion: Our multiple-case logic model provides generalisable information about the key core elements of the POPS service. This information can be used to aid the implementation of the POPS service in new healthcare settings.