Adhering to inpatient geriatric consultation recommendations

Area of Science:

• Geriatric Medicine
• Hospital Medicine
• Healthcare Quality Improvement

Background:

• Attending physician adherence to geriatric consultation recommendations is crucial for comprehensive patient care.
• Understanding factors influencing adherence can optimize geriatric consultation services.
• This study addresses a gap in knowledge regarding physician engagement with geriatric recommendations in community hospitals.

Purpose of the Study:

• To determine the rate of attending physician adherence to recommendations from inpatient geriatric consultations.
• To identify patient and physician factors associated with adherence to geriatric consultation recommendations.

Main Methods:

• Retrospective chart review of 47 patients referred for inpatient geriatric consultation over 1.5 years.
• Analysis of patient demographics, physician demographics, length of stay, patient discharge status, consultant expertise, diagnoses, and recommendation adherence.
• Multivariate analysis to identify factors associated with adherence.

Main Results:

• Recommendations covered medical, medication, laboratory, nutritional, and psychosocial domains, among others.
• Overall adherence to consultant recommendations was 55.5%.
• Decreasing length of hospital stay prior to consultation was significantly associated with higher physician adherence (P=.03), explaining over 40% of adherence variability.

Conclusions:

• Inpatient geriatric consultations provide valuable comprehensive assessments for attending physicians.
• Physician adherence to geriatric recommendations exceeds 50% and is not significantly influenced by patient or physician demographics.
• Adherence is moderately associated with shorter pre-consultation hospital stays, indicating potential for process improvement in hospital medicine.