scholarly journals Abstracts of the 17th Congress of the European Geriatric Medicine Society

2021 ◽  
Vol 12 (S1) ◽  
pp. 1-387
Keyword(s):  
Geriatric Medicine

Modelling In-Patient Bed Usage Behaviour in a Department of Geriatric Medicine

1993 ◽  
Vol 32 (01) ◽  
pp. 79-81 ◽  
Author(s):  
P. Millard ◽  
S. McClean
Keyword(s):  
Census Data ◽  
Geriatric Medicine ◽  
Temporal Trends ◽  
Exponential Model ◽  
Bed Occupancy ◽  
Lengths Of Stay ◽  
Geriatric Hospital ◽  
Using Data ◽  
Acute Patients

Abstract:The flow of patients through geriatric hospitals has been previously described in terms of acute and long-stay states where the bed occupancy at a census point is modelled by a mixed exponential model. Using data for sixteen years the model was fitted to successive annual census points, in order to provide a description of temporal trends. While the number of acute patients has remained fairly stable during the period, the model shows that there has been a decrease in the number of long-stay patients. Mean lengths of stay in our geriatric hospital before death or discharge have decreased during the study period for both acute and long-stay patients.Using these fits of the mixed exponential model to census data, a method is provided for predicting future turnover of patients. These predictions are reasonably good, except when the turnover patterns go through a period of flux in which assumption of stability no longer holds. Overall, a methodology is presented which relates census analysis to the behaviour of admission cohorts, thus producing a means of predicting future behaviour of patients and identifying where there is a change in patterns.

The Feasibility and Necessity of a Revolution in Geriatric Medicine

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Giacinto Libertini ◽  
◽  
Keyword(s):  
Geriatric Medicine

scholarly journals Bedside Ultrasound Measures of Muscle Mass and Frailty Measures in Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 269-269
Author(s):  
Kenneth Madden ◽  
Boris Feldman ◽  
Shane Arishenkoff ◽  
Graydon Meneilly
Keyword(s):  
Older Adults ◽  
Muscle Mass ◽  
Frailty Index ◽  
Geriatric Medicine ◽  
Muscle Thickness ◽  
Vancouver General Hospital ◽  
Community Dwelling ◽  
Point Of Care Ultrasound ◽  
Clinical Frailty Scale ◽  
Community Dwelling Older Adults

Abstract The age-associated loss of muscle mass and strength in older adults is called sarcopenia, and it is associated with increased rates of falls, fractures, hospitalizations and death. Sarcopenia is one of the most common physical etiologies for increased frailty in older adults, and some recent work has suggested the use of Point-of care ultrasound (PoCUS) measures as a potential measure of muscle mass. The objective of this study was to examine the association of PoCUS measures of muscle thickness (MT) with measures of frailty in community-dwelling older adults. We recruited 150 older adults (age >= 65; mean age 80.0±0.5 years, 66 women, 84 men) sequentially from 5 geriatric medicine clinics (Vancouver General Hospital). We measured lean muscle mass (LMM, by bioimpedance assay) and an ultrasonic measure of muscle quantity (MT, vastus medialis muscle thickness) in all subjects, as well as two outcome measures of frailty (FFI, Fried Frailty Index; RCFS, Rockwood Clinical Frailty Scale). In our models, MT showed an inverse correlation with the FFI (Standardized β=-0.2320±0.107, p=0.032) but no significant correlation with the RCFS (Standardized β = -0.025±0.086, p=0.776). LMM showed no significant association with either FFI (Standardized β=-0.232±0.120, p=0.055) or RCFS (Standardized β = -0.043±0.119, p=0.719). Our findings indicate that PoCUS measures show potential as a way to screen for physical manifestations of frailty and might be superior to other bedside methods such as bioimpedance assay. However, PoCUS measures of muscle thickness will likely miss patients showing frailty in the much broader context captured by the RCFS.

scholarly journals Experts’ preferences for sarcopenia outcomes: a discrete-choice experiment from a working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) in collaboration with the European Union of Geriatric Medicine Society (EUGMS)

2021 ◽  
Author(s):  
Charlotte Beaudart ◽  
◽  
Jürgen M. Bauer ◽  
Francesco Landi ◽  
Olivier Bruyère ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Musculoskeletal Diseases ◽  
Geriatric Medicine ◽  
Mixed Logit ◽  
The European Union ◽  
Domestic Activities

Abstract Background and aims To assess experts’ preference for sarcopenia outcomes. Methods A discrete-choice experiment was conducted among 37 experts (medical doctors and researchers) from different countries around the world. In the survey, they were repetitively asked to choose which one of two hypothetical patients suffering from sarcopenia deserves the most a treatment. The two hypothetical patients differed in five pre-selected sarcopenia outcomes: quality of life, mobility, domestic activities, fatigue and falls. A mixed logit panel model was used to estimate the relative importance of each attribute. Results All sarcopenia outcomes were shown to be significant, and thus, important for experts. Overall, the most important sarcopenia outcome was falls (27%) followed by domestic activities and mobility (24%), quality of life (15%) and fatigue (10%). Discussion and conclusion Compared to patient’s preferences, experts considered falls as a more important outcome of sarcopenia, while the outcomes fatigue and difficulties in domestic activities were considered as less important.

scholarly journals What is meant by “frailty” in undergraduate medical education? A national survey of UK medical schools

2021 ◽  
Vol 12 (2) ◽  
pp. 355-362
Author(s):  
Rebecca Winter ◽  
Muna Al-Jawad ◽  
Juliet Wright ◽  
Duncan Shrewsbury ◽  
Harm Van Marwijk ◽  
...  
Keyword(s):  
Medical Education ◽  
Learning Outcomes ◽  
Undergraduate Medical Education ◽  
Geriatric Medicine ◽  
Treatment Decision ◽  
Medical Schools ◽  
Educational Strategies ◽  
Treatment Decision Making ◽  
Negative Perceptions ◽  
Common Learning

Abstract Purpose All UK medical schools are required to include frailty in their curriculum. The term is open to interpretation and associated with negative perceptions. Understanding and recognising frailty is a prerequisite for consideration of frailty in the treatment decision-making process across clinical specialities. The aim of this survey was to describe how frailty has been interpreted and approached in UK undergraduate medical education and provide examples of educational strategies employed. Methods All UK medical schools were invited to complete an electronic survey. Schools described educational strategies used to teach and assess frailty and provided frailty-related learning outcomes. Learning Outcomes were grouped into categories and mapped to the domains of Outcomes for Graduates (knowledge, skills and values). Results 25/34 Medical schools (74%) participated. The interpretation of what frailty is vary widely and the diversity of teaching strategies reflect this. The most common Learning outcomes included as “Frailty” are about the concept of frailty, Comprehensive Geriatric Assessments and Roles of the MDT. Frailty teaching is predominantly opportunistic and occurred within geriatric medicine rotations in all medical schools. Assessments focus on frailty syndromes such as falls and delirium. Conclusion There is variation regarding how frailty has been interpreted and approached by medical schools. Frailty is represented in an array of teaching and assessment methods, with a lack of constructive alignment to related learning outcomes. Consensus should be agreed as to what frailty means in medical education. Further research is required to explore which frailty-specific educational strategies in undergraduate medical education enhance learning.

scholarly journals 144 The Use of a Multidisciplinary Team Discharge “Huddle” to Improve Patient Flow and Planning

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Mary Randles ◽  
Sylvia Hickey ◽  
Susanne Cotter ◽  
Carmel Walsh ◽  
Kieran O'Connor ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Multidisciplinary Team ◽  
Older Persons ◽  
Patient Flow ◽  
Geriatric Medicine ◽  
City Centre ◽  
Nurse Specialist ◽  
Complex Care ◽  
Clinical Nurse

Abstract Background Patient flow, the movement of patients is an integral part of the patient care pathway. With the goal of improving overall patient care and discharge planning, a hospital wide, multidisciplinary team based, patient discharge meeting or ‘HUDDLE’ was devised with the goal of facilitating onward care planning for all inpatients especially those with complex discharge needs in a city centre teaching hospital. Methods The patient flow huddle has evolved to include a Patient Flow Clinical Nurse Manager, Bed Manager, Medicine for Older Persons Clinical Nurse Specialist, Physiotherapist/Occupational Therapist, Consultant Geriatrician and Geriatric Medicine Registrar. Each team in the hospital are requested to attend at least twice a week. Predicted discharge dates are established. Teams discuss patients who have a requirement for rehabilitation, either short-term or complex rehabilitation and patients over 65 years who may need review from Older Persons Services .We sought to optimise issues including housing, home care packages, interim home supports, community intervention team referrals, integrated care and Nursing Home Support Scheme applications. Results There were 3918 Emergency Department presentations by adults over 75 in 2018 and 2113 admissions (3704, 2081 respectively in 2017). Accuracy for discharge within one day of PDD ranged from 52.5% (Jan) to 72.6 % (Nov). The average length of stay was 6.2days (SD 0.47). 172 patients (84 female, 88 male) were admitted for slow stream rehabilitation (median length of stay 30 days). Conclusion Rather than using a negative view of older adults as potential ‘bed blockers’, the discharge huddle allowed a pro-active approach to assist medical and surgical teams in the management and re-enablement of patients with complex care needs. Early identification of such patients with complex care and discharge needs allowed greater focus on appropriate planning earlier in the patient’s hospital journey.

Principles of Geriatric Medicine

1986 ◽  
Vol 61 (7) ◽  
pp. 606-607
Author(s):  
Eric G. Tangalos
Keyword(s):  
Geriatric Medicine
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