College for Geriatrics
1. State of the Art
2. Projects’ results
J.P.Baeyens et al. BVGG 2000
State of the art (1)
• Peer review 2000: 103/160 geriatric units
– 13 admissions/bed/year (median) – 50% admissions from private home – 46% home discharge
– median age = 82 yrs – length of stay 22 days
– median occupation rate 90% – multidisciplinary team
State of the art (2)
• 21 formation centers
• 37 fellow places available
College ’s projects
• 2000: peer review
• 2001: nutrition
• 2002: continence, emergency, radiotherapy
• 2003: BMDS, AGGIR, ...
• collaborations with the Colleges for:
– radiotherapy – nephrology
Nutrition program 2001
OUTCOMES OF CONTINUOUS PROCESS
IMPROVEMENT OF NUTRITIONAL CARE PROGRAM AMONG GERIATRIC UNITS IN BELGIUM
Nutrition program 2001
Methodology: 2 phases
Observation
• comprehensive geriatric assessment and MNA • routine nutritionIntervention
• comprehensive geriatric assessment and MNA • « Flow Chart» • « Meals on Wheels » approach 0 3 6 months±Std. Dev. ±Std. Err. Mean Phase 1 Phase 2 S T A Y ( d a y s ) 0 10 20 30 40 50 60
Nutrition program 2001
Conclusions
• high prevalence of malnutrition among geriatric hospitalized patients
• significant decreased hospitalization stay during 2nd phase (confounding factors ?)
• significant increased PAB concentrations during 2nd phase
DRIP
Detect, Reduce,
Incontinence, Programme
Thierry Pepersack on behalf of the College for Geriatrics
Continence 2002
Discussion
• 45% of incontinent patients in geriatric units • 26% of transient incontinence
• functional incontinence represents more than half of the chronic situations
• incontinence is associated with: – high length of stay
2003 - 2004
Belgian Minimal Geriatric
Screening Tools
Rationale
• the belgian geriatric program is associated with
the obligation of continuous registration of quality variables
• the ministry intends to ask us this registration
• the College for Geriatrics and the Belgian Society for Gerontology and Geriatrics think it would be better to choose ourselves these variables among the comprehensive geriatric assessment
Worksheet
• Part I:
2003 - questionnaire about Comprehensive Geriatric Assessment
• Part II:
2004 - consensus conference "Belgian
Minimum Geriatric Screening Tools »
• Part III:
www.geriatrie.be
Part I
Belgian Minimum Geriatric
Screening Tools
for Comprehensive Geriatric
Assessment
Results
• 59 questionnaires
Comprehensive Geriatric Assessment
• ADL • IADL • risk of falling • cognition • depression • social • nutrition • pain • QOLConclusions
Part I
quality of questionnaire not enough CGA
lack of uniformity CGA ~ no consensus
response rate
geriatricians : interested in CGA transparency of geriatric units
www.geriatrie.be
Part II
2004
Consensus Conference
"Belgian Minimum Geriatric
Screening Tools »
Working groups
ADL-IADL
P De Vriendt, G Dargent, C Swine
Mobility
JP Baeyens , Ghesquière
Cognition
M Lambert , E Gorus, C Sachem
Depression A Velghe, Th Pepersack Social JP Baeyens, H Vandekerkhof Nutrition T Pepersack, H Daniels, J Pétermans, C Gazzotti Pain N Vandennoorgate, A Pepinster Frailty C Swine, G Dargent, P De Vriendt www.geriatrie.be
www.geriatrie.be
Part III
2005
Topics choice
Results
52 51 38 32 26 23 16 12 0 10 20 30 40 50 60 mobility cognition frailty ADL Nutrition Social Depression PainPriorities
• geriatric programme
• programmation of beds
• adapted financial ressources • alternative services
– day hospital
– inpatients geriatric consultation service (multidisciplinary)
– for geriatric problems (confusion, denutrition, falls, incontinence, etc.)
