Evidence map›Paper›PMID 27669402›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie2017

Sustainability of a proactive geriatric trauma consultation service.

Camilla L Wong, Raghda Al Atia, Amanda McFarlan, Holly Y Lee, Christina Valiaveettil, Barbara Haas

Open access · bronzeAbstract read
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
14.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 136 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Camilla L WongFrom the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. (Wong, Al Atia); the Division of Geriatrics, St. Michael's Hospital, Toronto, Ont. (Wong); the Division of Trauma, St. Michael's Hospital, Toronto, Ont. (McFarlan); the Faculty of Medicine, University of Toronto, Toronto, Ont. (Lee, Valiaveettil); and the Department of Surgery, University of Toronto, Toronto, Ont. (Haas).
Raghda Al AtiaFrom the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. (Wong, Al Atia); the Division of Geriatrics, St. Michael's Hospital, Toronto, Ont. (Wong); the Division of Trauma, St. Michael's Hospital, Toronto, Ont. (McFarlan); the Faculty of Medicine, University of Toronto, Toronto, Ont. (Lee, Valiaveettil); and the Department of Surgery, University of Toronto, Toronto, Ont. (Haas).
Amanda McFarlanFrom the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. (Wong, Al Atia); the Division of Geriatrics, St. Michael's Hospital, Toronto, Ont. (Wong); the Division of Trauma, St. Michael's Hospital, Toronto, Ont. (McFarlan); the Faculty of Medicine, University of Toronto, Toronto, Ont. (Lee, Valiaveettil); and the Department of Surgery, University of Toronto, Toronto, Ont. (Haas).
Holly Y LeeFrom the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. (Wong, Al Atia); the Division of Geriatrics, St. Michael's Hospital, Toronto, Ont. (Wong); the Division of Trauma, St. Michael's Hospital, Toronto, Ont. (McFarlan); the Faculty of Medicine, University of Toronto, Toronto, Ont. (Lee, Valiaveettil); and the Department of Surgery, University of Toronto, Toronto, Ont. (Haas).
Christina ValiaveettilFrom the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. (Wong, Al Atia); the Division of Geriatrics, St. Michael's Hospital, Toronto, Ont. (Wong); the Division of Trauma, St. Michael's Hospital, Toronto, Ont. (McFarlan); the Faculty of Medicine, University of Toronto, Toronto, Ont. (Lee, Valiaveettil); and the Department of Surgery, University of Toronto, Toronto, Ont. (Haas).
Barbara HaasFrom the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. (Wong, Al Atia); the Division of Geriatrics, St. Michael's Hospital, Toronto, Ont. (Wong); the Division of Trauma, St. Michael's Hospital, Toronto, Ont. (McFarlan); the Faculty of Medicine, University of Toronto, Toronto, Ont. (Lee, Valiaveettil); and the Department of Surgery, University of Toronto, Toronto, Ont. (Haas).
University of Alberta · CAInstitute of Health Economics · CAÖrebro University · SEAlberta Health Services · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProactive geriatric trauma consultation service (GTCS) models have been associated with better delivery of geriatric care and functional outcomes. Whether such collaborative models can be improved and sustained remains uncertain. We describe the sustainability and process improvements of an inpatient GTCS.

methodsWe assessed workflow using interviews and surveys to identify opportunities to optimize the referral process for the GTCS. Sustainability of the service was assessed via a prospective case series (July 2012-December 2013). Study data were derived from a review of the medical record and trauma registry database. Metrics to determine sustainability included volume of cases, staffing levels, rate of adherence to recommendations, geriatric-specific clinical outcomes, trauma quality indicators, consultation requests and discharge destination.

resultsThrough process changes, we were able to ensure every eligible patient was referred for a comprehensive geriatric assessment. Compared with the implementation phase, volume of assessments increased and recommendation adherence rates were maintained. Delirium and/or dementia were the most common geriatric issue addressed. The rate of adherence to recommendations made by the GTCS team was 88.2%. Only 1.4% of patients were discharged to a nursing home.

conclusionWorkflow assessment is a useful means to optimize the referral process for comprehensive geriatric assessment. Sustainability of a GTCS was shown by volume, staffing and recommendation adherence.

Indexed as

Geriatric AssessmentWorkflowAgedAged, 80 and overFemaleGeriatricsGuideline AdherenceHealth Services ResearchHumansMaleOutcome and Process Assessment, Health CareReferral and Consultation

Identifiers

PMID27669402
PMCPMC5373738
OpenAlexW2527385378

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.