American Geriatrics Society 2015 Annual Scientific Meeting location:National Harbor, Maryland date:14-17 May 2015
Background: GCTs are multidisciplinary teams advising and sensitizing healthcare professionals in the hospital for elderly care. They were large-scale implemented in the Netherlands, France, and Belgium despite lacking evidence on effectiveness. This study aimed to understand how GCT implementation was facilitated.
Methods: Systematic database and grey literature search; cross-sectional survey.
Results: GCT implementation was supported using a Senior Friendly Hospital (SFH) Quality Label in the Netherlands, and legislation in France and Belgium. Forty-six (47%) hospitals in the Netherlands were awarded the Quality Label in 2013 and 82 (83%) had a GCT. The majority (n = 56, 68%) of the GCTs scored 75% or more on the GCT quality indicators, a minimal standard for SFH eligibility. The Dutch National Society for Clinical Geriatrics specified different ways to implement consultation based interventions: clinical geriatric consults, geriatric or structural comanagement. In 2002 the Ministry of Health in France decreed on the Geriatric Care Network (GCN) for better elderly management stating that the GCN should include a GCT and a geriatric unit, short-stay unit, day hospital and rehabilitation unit. It also regulated GCT activities and provided the possibility for out of hospital consultation. In 2011, 216 French public acute care hospitals (31%) had a GCT. In Belgium a Care Program for Older Hospitalized Patients was published in 2007, and revised in 2014, by the Ministery of Public Health: acute hospitals should have an acute geriatric hospitalization ward, outpatient’s clinic, and day care hospital, a GCT, and an external liaison service. Over 90% of 108 Belgian acute hospitals had a GCT in 2013. Structural financing for GCT activities is provided since 2014. For evaluating GCTs, France and the Netherlands apply quality indicators. Conclusions: Although a heterogeneous approach for patient screening, assessment, and follow-up was found, legislation, structural financing and quality indicators were facilitators to promote implementation of geriatric care models on a national level in Europe.