From research to bedside: Incorporation of a CGA-based frailty index among multiple comanagement services.
From research to bedside: Incorporation of a CGA-based frailty index among multiple comanagement services.
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DOI：
10.1111/jgs.17446
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发表时间：
2022-01
影响因子：
6.3
通讯作者：
Javedan, Houman
中科院分区：
文献类型：
--
作者：
Cooper, Lisa;Loewenthal, Julia;Frain, Laura N.;Tulebaev, Samir;Cardin, Kristin;Hshieh, Tammy T.;Dumontier, Clark;Streiter, Shoshana;Joseph, Carly;Hilt, Austin;Theou, Olga;Rockwood, Kenneth;Orkaby, Ariela R.;Javedan, Houman
综合老年评估(CGA)是不同临床环境的老年医生用来识别脆弱性和估计老年人生理储备的核心工具。在这篇文章中，我们展示了我们机构的迭代过程，以确定和开发一个可行的、可接受的和可持续的基于CGA的床边脆弱性指数工具(FI-CGA)，该工具不仅对脆弱性进行量化和评级，而且提供了一种统一的方式，以便与其他团队有效地沟通复杂的老年概念，如储备和脆弱性。我们描述了我们将FI-CGA合并到电子健康记录(EHR)中并在临床服务中传播的情况。我们证明，从2018年到2020年，越来越多的患者在他们的初步评估中记录了FI-CGA，同时建立了额外的管理服务(图2)。FI-CGA的可接受性和可持续性，以及它在我们部门的老年医生的常规使用，通过一项调查得到了证明，其中大多数临床医生报告在评估新患者时使用FI-CGA，并且FI-CGA为他们的临床管理提供信息。最后，我们展示了我们如何改进和更新FI-CGA，我们提供了FI-CGA在整个机构中的应用实例，并描述了正在进行的流程改进的领域以及在不同的住院和门诊服务中使用这一定制但标准化的工具所面临的挑战。概述的过程可以被其他老年科用来引入和纳入FI-CGA。
The comprehensive geriatric assessment (CGA) is the core tool used by geriatricians across diverse clinical settings to identify vulnerabilities and estimate physiologic reserve in older adults. In this paper, we demonstrate the iterative process at our institution to identify and develop a feasible, acceptable, and sustainable bedside CGA-based frailty index tool (FI-CGA) that not only quantifies and grades frailty but also provides a uniform way to efficiently communicate complex geriatric concepts such as reserve and vulnerability with other teams. We describe our incorporation of the FI-CGA into the electronic health record (EHR) and dissemination among clinical services. We demonstrate that an increasing number of patients have documented FI-CGA in their initial assessment from 2018 to 2020, while additional comanagement services were established (Figure 2). The acceptability and sustainability of the FI-CGA, and its routine use by geriatricians in our division, were demonstrated by a survey where the majority of clinicians report using the FI-CGA when assessing a new patient and that the FI-CGA informs their clinical management. Finally, we demonstrate how we refined and updated the FI-CGA, we provide examples of applications of the FI-CGA across the institution and describe areas of ongoing process improvement and challenges for the use of this tailored yet standardized tool across diverse inpatient and outpatient services. The process outlined can be used by other geriatric departments to introduce and incorporate an FI-CGA.
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DOI：
10.1111/j.1532-5415.2009.02667.x
发表时间：
2010-02-01
影响因子：
6.3
作者：
Rockwood, Kenneth;Rockwood, Michael R. H.;Mitnitski, Arnold
通讯作者：
Mitnitski, Arnold
影响因子：
6.3
作者：
Cooper, Lisa;Abbett, Sarah K.;Bader, Angela M.
通讯作者：
Bader, Angela M.
影响因子：
39
作者：
Kim, Dae Hyun;Afilalo, Jonathan;Lipsitz, Lewis A.
通讯作者：
Lipsitz, Lewis A.
影响因子：
6.3
作者：
Callahan KE;Clark CJ;Edwards AF;Harwood TN;Williamson JD;Moses AW;Willard JJ;Cristiano JA;Meadows K;Hurie J;High KP;Meredith JW;Pajewski NM
通讯作者：
Pajewski NM
影响因子：
9
作者：
Saxton, Adrienne;Velanovich, Vic
通讯作者：
Velanovich, Vic