The population of baby boomers and geriatric adults—the “boomeratric”™ generation—is continuing to increase in the United States. Roughly 40 million Americans are 65 or older, representing 12.9% of the total population (or one in every eight people). There will also be about 72.1 million older Americans by 2030, a growth of about 19%. As the boomeratric™ generation continues to age, they become increasingly prone to falls and fractures because of their frailty. Timely evaluation and treatment after bone fractures lead to better outcomes.

At Geisinger Health System and other medical centers throughout the country, hospitals are starting to establish geriatric fracture care programs. These initiatives utilize evidence-based medicine to address the aging population and a complete team approach to provide quality comprehensive care. Using the latest research, a series of protocols is followed to deliver best practice medicine throughout the entire care process. Geriatric fracture care programs connect patients with the resources they need to expedite recovery and help them take steps to stay healthy and prevent future injury.

Coordinated, Evidence-Based Care

Members of the geriatric fracture care team include nurse coordinators, emergency physicians, physical and occupational therapies, orthopedic surgeons, hospitalists, pharmacists, care managers, physician assistants, rheumatologists, dietitians, blood conservation services, and nurses. Nurse coordinators play an integral role in streamlining processes—speaking with patients regularly, keeping track of their progress, and guiding them throughout the care process. It’s their job to facilitate family involvement in the care of patients to improve outcomes. They also help maintain centralized electronic medical records and order sets. These enable all members of the geriatric fracture care team to stay up to date and informed on each individual’s status. As the processes become more efficient, patients benefit with reductions in costs and shorter lengths of stay in the hospital.

“Geriatric fracture care programs connect patients with the resources they need to expedite recovery.”

Orthopedic surgeons who have vast experience in caring for older patients are another critical component for geriatric fracture care programs to be effective. Their advanced training and adherence to carefully following designed protocols can improve outcomes. Along with other team members, they help ensure that patients reach their goals and return to the activities they enjoyed prior to their injury. As part of the program, patients are educated on causes of fragility fractures; bone density loss; necessary medications for their condition(s); and avoiding risks and preventing injuries in the future.

Recognizing the Value

Geisinger Health System is just one institution in the U.S. that recognizes the value of implementing initiatives like a geriatric fracture care program. These programs provide high-quality care that can lead to significant healthcare cost savings and reductions in future hospitalizations while streamlining the continuum of care. They improve quality of care because they use evidence-based medicine. Internal patient data are mined and cultivated electronically to further enhance outcomes. Physicians throughout the nation should seek to champion such efforts in their institutions, no matter how big or small they might be.

As more hospital systems see the value of such programs—in terms of outcomes, quality of care, and healthcare costs—the hope is that this trend will become the norm rather than the exception.

 

References

For information on Geisinger Health System’s Geriatric Fracture Care program, go tohttp://www.geisinger.org/services/orthopaedics/fractures/geriatric.html.

Neuman MD, Speck RM, Karlawish JH, Schwartz JS, Shea JA. Hospital protocols for the inpatient care of older adults: results from a statewide survey. J Am Geriatr Soc. 2010;58:1959-1964.

de Vries OJ, Peeters GM, Elders PJ, et al. Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial. Arch Intern Med. 2010;170:1110-1117.

Haaland DA, Cohen DR, Kennedy CC, Khalidi NA, Adachi JD, Papaioannou A. Closing the osteoporosis care gap: increased osteoporosis awareness among geriatrics and rehabilitation teams.BMC Geriatr. 2009;9:28.