What is known?
Postoperative outcomes worsen with increasing age. Services using comprehensive geriatric assessment (CGA) methodology throughout the perioperative pathway demonstrate improvement in postoperative outcomes. Despite clear standards of care recommending assessment by a geriatrician in high-risk surgical groups, implementation of geriatric medicine services in routine surgical care (other than hip fracture) remains limited.
What is the question?
Is it possible to effectively and sustainably translate an established model of geriatrician-led perioperative care (perioperative medicine for older people undergoing Surgery (POPS)) from a tertiary centre to a district general hospital setting?
What was found?
A sustainable and substantively funded POPS service was established at a district general hospital. Within 18 months the service demonstrated reduction in length of stay and readmission rate, and improvement in patient- and staff-related outcomes.
What is the implication for practice now?
Quality improvement methodology should be used to facilitate the wider systematic scale-up of sustainable POPS services.