PT  - JOURNAL ARTICLE
AU  - Ruth de Las Casas
AU  - Catherine Meilak
AU  - Anna Whittle
AU  - Judith Partridge
AU  - Jacek Adamek
AU  - Euan Sadler
AU  - Nick Sevdalis
AU  - Jugdeep Dhesi
TI  - Establishing a perioperative medicine for older people undergoing surgery service for general surgical patients at a district general hospital
AID  - 10.7861/clinmed.2021-0356
DP  - 2021 Nov 01
TA  - Clinical Medicine
PG  - e608--e614
VI  - 21
IP  - 6
4099  - http://www.rcpjournals.org/content/21/6/e608.short
4100  - http://www.rcpjournals.org/content/21/6/e608.full
SO  - Clin Med2021 Nov 01; 21
AB  - Introduction There is growing recognition of the need for perioperative medicine services for older surgical patients. Comprehensive geriatric assessment and optimisation methodology has been successfully used to improve perioperative outcomes at tertiary centres. This paper describes translation of an established model of geriatrician-led perioperative care to a district general hospital (DGH) setting.Methods A mixed methods quality improvement programme was used and included stakeholder co-design, identification of core components, definition of mechanisms for change, and measurement of impact through qualitative and quantitative approaches.Results Within 18 months, a substantive perioperative service for older people was established at a DGH, funded by the surgical directorate. Key outcomes included reduction in length of stay and 30-day readmission and positive staff and patient experience.Discussion This study is in keeping with improvement science literature demonstrating the importance of a mixed-methods approach in translating an evidenced-based intervention into another setting, maintaining fidelity and replicating results.