Building Geriatric Trauma Programs in Resource-Constrained Environments: Trauma Quality Improvement Program Guideline...

Area of Science:

• Geriatric Trauma Care
• Patient Safety
• Healthcare Quality Improvement

Background:

• The American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) updated guidelines in 2021 for geriatric trauma patient care.
• Two Los Angeles County safety net hospitals faced challenges in implementing these guidelines due to geriatrician shortages and limited resources.

Purpose of the Study:

• To develop and implement a strategy for identifying and managing high-risk geriatric trauma patients in resource-constrained safety net hospitals.
• To improve adherence to updated geriatric trauma care guidelines.

Main Methods:

• A needs assessment identified a lack of standardized processes for geriatric trauma patient identification and care.
• A resident-led frailty screening protocol was implemented for all trauma patients aged 60 and older.
• Electronic Medical Record (EMR) documentation forms were developed to streamline data capture and monitoring.

Main Results:

• The frailty screening process successfully identified high-risk geriatric trauma patients.
• Frailty screening compliance increased from 37% to 81% over the study period (August 2022-April 2023).
• A systematic process for identifying, triaging, and consulting high-risk geriatric trauma patients was established.

Conclusions:

• Creativity, collaboration, and resourcefulness enabled the implementation of TQIP guidelines in safety net hospitals.
• A sustainable process is now in place for optimizing medical comorbidities in high-risk geriatric trauma patients.
• Continued interdisciplinary collaboration is essential for optimal care of older injured patients.