Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 30:3:1249832.
doi: 10.3389/frhs.2023.1249832. eCollection 2023.

From research to daily clinical practice: implementation of orthogeriatric co-management in the trauma ward

Sigrid Janssens  1 , Mieke Deschodt  1   2 , Marian Dejaeger  1   3 , Katleen Fagard  1   3 , Marie Cerulus  2   3 , Heidi Cosyns  3 , Johan Flamaing  1   3 , Michiel Herteleer  4   5 , An Sermon  4   5
Affiliations

From research to daily clinical practice: implementation of orthogeriatric co-management in the trauma ward

Sigrid Janssens et al. Front Health Serv. .

Abstract

Introduction: Evidence strongly suggests that orthogeriatric co-management improves patient outcomes in frail older patients with a fracture, but evidence regarding how to implement this model of care in daily clinical practice is scarce. In this paper, we first describe the implementation process and selection of implementation strategies for an orthogeriatric co-management program in the traumatology ward of the University Hospitals Leuven in Belgium. Second, we report the results of a multi-method feasibility study. This study (1) measures the fidelity towards the program's core components, (2) quantifies the perceived feasibility and acceptability by the healthcare professionals, and (3) defines implementation determinants.

Methods: Implementation strategies were operationalized based on the Expert Recommendations for Implementing Change (ERIC) guidelines. In the feasibility study, fidelity towards the core components of the program was measured in a group of 15 patients aged 75 years and over by using electronic health records. Feasibility and acceptability as perceived by the involved healthcare professionals was measured using a 15-question survey with a 5-point Likert scale. Implementation determinants were mapped thematically based on seven focus group discussions and two semi-structured interviews by focusing on the healthcare professionals' experiences.

Results: We observed low fidelity towards completion of a screening questionnaire to map the premorbid situation (13%), but high fidelity towards the other program core components: multidimensional evaluation (100%), development of an individual care plan (100%), and systematic follow-up (80%). Of the 50 survey respondents, 94% accepted the program and 62% perceived it as feasible. Important implementation determinants were feasibility, awareness and familiarity, and improved communication between healthcare professionals that positively influenced program adherence.

Conclusions: Fidelity, acceptability, and feasibility of an orthogeriatric co-management program were high as a result of an iterative process of selecting implementation strategies with intensive stakeholder involvement from the beginning.

Clinical trial registration: [https://www.isrctn.com/ISRCTN20491828], International Standard Randomised Controlled Trial Number (ISRCTN) Registry: [ISRCTN20491828]. Registered on October 11, 2021.

Keywords: feasibility study; geriatrics; implementation science; nursing model; osteoporotic fractures.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of the G-COMAN program.
Figure 2
Figure 2
G-COMAN implementation determinants grouped per domain according to the framework of contextual analysis by Flottorp et al. (35).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Palmer K, Villani ER, Vetrano DL, Cherubini A, Cruz-Jentoft AJ, Curtin D, et al. Association of polypharmacy and hyperpolypharmacy with frailty states: a systematic review and meta-analysis. Eur Geriatr Med. (2019) 10(1):9–36. 10.1007/s41999-018-0124-5 - DOI - PubMed
    1. Vetrano DL, Palmer K, Marengoni A, Marzetti E, Lattanzio F, Roller-Wirnsberger R, et al. Frailty and multimorbidity: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. (2019) 74(5):659–66. 10.1093/gerona/gly110 - DOI - PubMed
    1. Kim HJ, Park S, Park SH, Park J, Chang BS, Lee CK, et al. Prevalence of frailty in patients with osteoporotic vertebral compression fracture and its association with numbers of fractures. Yonsei Med J. (2018) 59(2):317–24. 10.3349/ymj.2018.59.2.317 - DOI - PMC - PubMed
    1. Kwak MJ, Digbeu BD, des Bordes J, Rianon N. The association of frailty with clinical and economic outcomes among hospitalized older adults with hip fracture surgery. Osteoporos Int. (2022) 33(7):1477–84. 10.1007/s00198-021-06215-8 - DOI - PubMed
    1. Falls: applying all our health—GOV.UK. (2022). Available at: https://www.gov.uk/government/publications/falls-applying-all-our-health... (Accessed April 18, 2023).

LinkOut - more resources