Knowledge Bank

Background The United States’ population of older adults is expected to surpass 87 million by the year 2050. Trauma is the leading cause of morbidity and mortality. Despite appropriate trauma resources, the older adult cannot handle the trauma impact, due to natural biologic changes and medical comorbidites. As the population continues to age, partnership between trauma and geriatric services is paramount to provide optimal care.

Purpose The purpose of this quality improvement project was to evaluate the implementation of an evidence-based practice frailty pathway on length of stay and 30-day read mission rates in geriatric trauma patients.

Methods The frailty pathway was revised at a Midwest academic medical center hospital, which included all patients older than 70 receiving a geriatric consult. Staff was educated in an individual and group setting. Pre- and post-implementation data were collected, including hospital length of stay, number of geriatric consults, 30-day read mission rates, percentage of frailty screening, and in-hospital complications.

Results From 2022 to 2023, geriatric patients increased from 315 to 360 patients. Despite no increase in frailty screening or geriatric consults, the hospital length of stay decreased from 6.56 to 6.39 days and readmission rates stayed consistent from 2.53 to 2.77%.

Implication for Practice Despite the unexpected setting challenges and 115% increase in patient census, hospital length of stay for geriatric trauma patients decreased and hospital readmission rates stayed consistent with the implementation of a geriatric frailty pathway.