Evaluation of the activity of a Functional and Interdisciplinary (Social and Healthcare) Geriatric Unit (FISHGU) for hospitalized patients at an acute hospital

Abstract

Introduction : The Functional and Interdisciplinary (Social and Healthcare) Geriatric Unit (FISHGU) or “UFISS de Gariatria in Spanish” (Unidad Funcional Interdisciplinar Sociosanitaria) is a multidisciplinary team provides management and multidimensional geriatric assessment for hospitalized patients at acute care hospital. They also play a role in the coordination of resources between the different levels of care. The FISHGU (UFISS de Geriatria) of Hospital Sociosanitario Francoli (HSSF) was created and set up in 2002. The team is composed of 2 physicians experienced in geriatric medicine, 1 clinical nurse specialist and 1 social worker. It is located on the 2nd Floor of HSSF, and the standard hours of workdays are 35 hours a week and 7 hours a day from 08:00 to 15:00 hours. Its scope of activity is hospital wards of acute care hospital, basic areas of primary care and coordination with other hospitals. Aims : - Our team completed multidimensional geriatric assessments. - Inpatient care of elderly with multiple co-morbidities (Chronic Complex Patients and Terminal Chronic Diseases Patients) that requires global and close attention (physical, psychological and social) to the special needs (occupational and physical therapy, etc) and geriatric syndromes that arise in this vulnerable population. Functions : - Acute hospital-wide consultation team with direct control over implementation of recommendations. - An ORTHOGERIATRIC collaborative intervention program for fragility fractures. - Comprehensive discharge planning with acute hospital wards. - Coordination with Nurse Case Manager of acute hospital. - Coordination of resources between the different levels of care (primary care teams, intermediate care facilities and acute hospital care). - Collaboration with the Interdisciplinary Assessment Committee of The Healthcare Region of Tarragona (CIMSS). Results : - During 2014, 838 assessments have been conducted. Eighty one patients more than 2013. - 35.2% of assessments were collected from Traumatology and ORTHOPEDIC Surgery, 22% Internal Medicine, 10.1% Neurology, 4.7% Rehabilitation unit, 4.4% Vascular Surgery, 4% Cardiology, 3.8% Gastroenterology, 2.8% Pneumology, 2.5% General Surgery, 2.5% Case Management, 2% Neurosurgery, and 2.3 others. - 99.6% has been evaluated on the same day. The remaining 0.4% % was assessed on the next day. - The time until admission to HSSF since the assessment of the FISHGU was within 48 hours in 33.2% of patients, 28% less than 4th day, and the remaining cases between 6-10 days. - 24% of the total were proactive evaluations. Conclusions : Based on the above mentioned data: - It has been demonstrated 11% increasing activity over the previous year, due to the ORTHOGERIATRIC programme. - Our FISHGU is a multidimensional unit, and growing proactivity (24%) due to the periodic and regular sessions with Traumatology, Neurology, Rehabilitation and Internal Medicine. - We believe that depending on the screening and targeting criteria used to identify eligible patients, the potential for impact could be quite large and raises the question of the physical and manpower capacity of the FISHGU to meet the apparent demand.