Optimisation de la qualité des soins et du rétablissement chirurgical chez les personnes âgées

 

Simon Bergman

Institut Lady Davis de recherches médicales de l'Hôpital général juif

 

Domaine : vieillissement

Programme chercheurs-boursiers cliniciens - Junior 1

Concours 2014-2015

By 2020, elderly patients will constitute 75% of the surgical workload. Surgical care of older persons is often associated with impairment of functional status, influencing the recovery process. This program will measure quality of care using process-based quality indicators (QIs) specific to geriatric and surgical care. The research question is: Does the optimization of the quality of surgical care of elderly people improve their recovery

The aim of study 1 is to understand surgical recovery and its association with quality of care. This study, that allows a 6-month follow-up of patients, is already ongoing at our institution, as a grant was obtained in 2012. An evaluation will be conducted before surgery to obtain data on demographics, general health, frailty, nutritional, psychological, functional, and cognitive status. To describe recovery, a subset of these measures will be repeated at 1 week, 1, 3, and 6 months following surgery. Medical records of the patients will be reviewed to measure adherence to QIs. A preliminary analysis of 100 patients having completed their 6-month follow-up will guide the development of study 2.

The aim of study 2 is to develop a perioperative checklist for use in elderly surgical patients and to assess how implementing such a checklist improves process of care adherence. One hundred new patients who will be undergoing abdominal surgery in one of the two sites will be assessed before surgery. The assessment will be the same as for study 1. Data of a pre-implementation checklist group of 50 patients will be evaluated and, then compared to a post-implementation checklist group of 50 patients. Medical records of the 100 patients will be reviewed to measure adherence to QIs.