COMMUNITY-BASED COMPREHENSIVE GERIATRIC ASSESSMENT CLINICAL DECISION ALGORITHMS AND PRACTICE GUIDELINES

Abstract

The Comprehensive Geriatric Assessment (CGA) has been suggested as the gold standard for the management of frailty in older people (British Geriatrics Society (BGS) 2014). It is a multi-dimensional process that requires expert clinical judgement and evidence-informed practices in order to gather, synthesize and interpret information of the client’s medical, social, psychological, physical and functional limitations to develop an integrated clinical profile and an individualized care plan (Kay, et al., 2017). Although the domains of the CGA are clearly documented, (Kay, et al., 2017), the intricacies of what to ask within the domains are not. The BGS practice guidelines for managing frailty suggest the need to develop local protocols and pathways of care to help guide assessment and treatment (BGS, 2014). The Regional Geriatric Program of Eastern Ontario’s Geriatric Assessment Outreach Team completed an evidence-based review to develop clinical decision algorithms for 15 domains within the CGA to support a practice that is effective and efficient. This poster will highlight the process and clinical outcomes of the 5-step evidence-based process that was used to develop a interview guide, decision algorithms and practice guidelines for 15 clinical topics for a CGA within a community context. These were developed to increase consistency amongst their interprofessional geriatric assessors and provide a practice framework that supported conscious competent clinical decision making. This poster will also highlight the challenges and opportunities of completing an evidence-based review with the provision of recommendations for other teams interested embarking on this type of clinical journey.