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Lucke JA, Mooijaart SP, Heeren P, Singler K, McNamara R, Gilbert T, Nickel CH, Castejon S, Mitchell A, Mezera V, Van der Linden L, Lim SE, Thaur A, Karamercan MA, Blomaard LC, Dundar ZD, Chueng KY, Islam F, de Groot B, Conroy S. Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine. Eur Geriatr Med 2021; 13:309-317. [PMID: 34738224 PMCID: PMC8568564 DOI: 10.1007/s41999-021-00578-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/20/2021] [Indexed: 01/08/2023]
Abstract
Aim The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe. Findings Eight posters with expert clinical guidelines on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/. Message Expert clinical recommendations for Geriatric Emergency Medicine in Europe were created and are ready for dissemination across Europe. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00578-1. Purpose Despite the rapidly expanding knowledge in the field of Geriatric Emergency Medicine in Europe, widespread implementation of change is still lacking. Many opportunities in everyday clinical care are missed to improve care for this susceptible and growing patient group. The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe. Methods A group of multi-disciplinary experts in the field of Geriatric Emergency Medicine in Europe was assembled. Using a modified Delphi procedure, a prioritized list of topics related to Geriatric Emergency Medicine was created. Next, a multi-disciplinary group of nurses, geriatricians and emergency physicians performed a review of recent guidelines and literature to create recommendations. These recommendations were voted upon by a group of experts and placed on visually attractive posters. The expert group identified the following eight subject areas to develop expert recommendations on: Comprehensive Geriatric Assessment in the Emergency Department (ED), age/frailty adjusted risk stratification, delirium and cognitive impairment, medication reviews in the ED for older adults, family involvement, ED environment, silver trauma, end of life care in the acute setting. Results Eight posters with expert clinical recommendations on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/. Conclusion Expert clinical recommendations for Geriatric Emergency Medicine may help to improve care for older patients in the Emergency Department and are ready for dissemination across Europe. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00578-1.
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Affiliation(s)
- J A Lucke
- Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands.
| | - S P Mooijaart
- Department of Internal Medicine, Section on Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - P Heeren
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.,Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - K Singler
- Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private, Medical University, Nuremberg, Germany.,Institute for Biomedicine of Ageing, Friedrich-Alexander-University, Erlangen-Nuremberg, Erlangen, Germany
| | - R McNamara
- Department of Emergency Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - T Gilbert
- Department of Geriatric Medicine, Lyon-Sud University Hospital, Lyon, France
| | - C H Nickel
- Emergency Medicine, University Hospital Basel, Basel, Switzerland
| | - S Castejon
- Department of Geriatrics and Palliative Care, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
| | - A Mitchell
- Department of Emergency Medicine, Sligo University Hospital, Sligo, Ireland
| | - V Mezera
- Geriatric Center, Pardubice Hospital, Pardubice, Czech Republic
| | - L Van der Linden
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.,Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - S E Lim
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
| | - A Thaur
- Department of Emergency Medicine, Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | - M A Karamercan
- Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - L C Blomaard
- Department of Internal Medicine, Section on Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Z D Dundar
- Department of Emergency Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - K Y Chueng
- Accident and Emergency Department, United Christian Hospital, Kwun Tong, Hong Kong
| | - F Islam
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - B de Groot
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - S Conroy
- Geriatric Medicine, MRC Unit for Lifelong Health and Ageing at UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK
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Kenis C, Heeren P, Decoster L, Van Puyvelde K, Conings G, Cornelis F, Cornette P, Moor R, Luce S, Libert Y, Van Rijswijk R, Jerusalem G, Rasschaert M, Langenaeken C, Baitar A, Specenier P, Geboers K, Vandenborre K, Debruyne PR, Vanoverbeke K, Van den Bulck H, Praet JP, Focan C, Verschaeve V, Nols N, Goeminne JC, Petit B, Lobelle JP, Flamaing J, Milisen K, Wildiers H. A Belgian Survey on Geriatric Assessment in Oncology Focusing on Large-Scale Implementation and Related Barriers and Facilitators. J Nutr Health Aging 2016; 20:60-70. [PMID: 26728935 DOI: 10.1007/s12603-016-0677-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study is to describe a large-scale, Belgian implementation project about geriatric assessment (=GA) in daily oncology practice and to identify barriers and facilitators for implementing GA in this setting. Design / setting / participants: The principal investigator of every participating hospital (n=22) was invited to complete a newly developed questionnaire with closed- and open-ended questions. The closed-ended questions surveyed how GA was implemented. The open-ended questions identified barriers and facilitators for the implementation of GA in daily oncology practice. Descriptive statistics and conventional content analysis were performed as appropriate. RESULTS Qualifying criteria (e.g. disease status and cancer type) for GA varied substantially between hospitals. Thirteen hospitals (59.1%) succeeded to screen more than half of eligible patients. Most hospitals reported that GA data and follow-up data had been collected in almost all screened patients. Implementing geriatric recommendations and formulating new geriatric recommendations at the time of follow-up are important opportunities for improvement. The majority of identified barriers were organizational, with high workload, lack of time or financial/staffing problems as most cited. The most cited facilitators were all related to collaboration. CONCLUSION Interventions to improve the implementation of GA in older patients with cancer need to address a wide range of factors, with organization and collaboration as key elements. All stakeholders, seeking to improve the implementation of GA in older patients with cancer, should consider and address the identified barriers and facilitators.
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Affiliation(s)
- C Kenis
- Hans Wildiers, Herestraat 49, 3000 Leuven, Belgium, Tel.: +32 16 34 69 20, Fax.: +32 16 34 69 01, E-mail address:
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Kenis C, Heeren P, Bron D, Decoster L, Van Rijswijk R, Jerusalem G, Rasschaert M, Langenaeken C, Pepersack T, Moor R, Lobelle JP, Flamaing J, Milisen K, Wildiers H. Implementation of geriatric assessment in Belgian patients with cancer: A multicenter survey on treating physicians' general experiences and expectations. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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