Change Narrative Abstract - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Expanding shared care perioperative services at Sir Charles Gairdner Hospital – Neurosurgery – Geriatrics: A New Horizon (#206)

Lisa Redgrave 1 , Sook Ting Lee 1 , Kien Chan 1 , Karen Quinlan 1 , Denise Glennon 1 , Sushmitha Prakash 1
  1. Sir Charles Gairdner Hospital, Perth, WA, Australia

Background

 

Sir Charles Gairdner Hospital (SCGH) in Western Australia is a 600-bed tertiary hospital with established Orthogeriatrics and Vascular-geriatrics shared care services. The Neurosurgical department is the quarternary centre for neurosurgery in WA with a 45 bed unit. In July 2021-June 2022 a total 1454 patients were treated in the department of which 34% were over 65 years old (62 % emergency and 35% elective).

 

 

Change

 

In 2021, the Geriatric and Acute Rehabilitation Medicine (GARM) department embarked on a pilot shared-care model of service with the Neurosurgery department. This was modelled on the successful Orthogeriatric and Vascular-geriatric services with embedded Consultant Geriatrician and Medical Registrar presence on the surgical ward providing proactive consultation for patients aged 65 and over.

 

This is the first service of its kind reported in Australia.

 

Learnings

 

The success of the Neurosurgical-Geris service was built upon years of experience with the Orthogeriatrics and Vascular-geriatrics services.

 

The importance of building relationships

  • Gaining the trust of surgical colleagues by focusing on a collaborative care model, with open lines of communication and shared decision making  
  • Establishing ground rules to reassure surgical teams our service intends to complement and not interfere with their patient’s surgical care.

 

Getting Hospital Executive Support

  • Collecting robust data to demonstrate a financial benefit to the hospital and improved safety and quality metrics from the service (e.g.: cost analysis, bed day savings, reduced hospital acquired complications, readmission rates, compliance with NSQHS standard 5 Comprehensive Care, emphasizing the additional benefit of a multidisciplinary medical model

 

Delivery of better comprehensive care to the older surgical inpatient; supporting and building the ward Multidisciplinary team; providing additional support and education to junior doctors on surgical rotations to enhance training and wellbeing