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[认证老年创伤中心中老年医学与创伤外科的合作:对不同护理模式及认证要求实施情况的见解]

[Cooperation of geriatrics and trauma surgery in certified geriatric trauma centers : Insights into different care models and the implementation of requirements resulting from certification].

作者信息

Roigk Patrick, Becker Clemens, Pfeiffer Klaus, Bühl Kerstin, Büchele Gisela, Rothenbacher Dietrich, König H H, Konnopka Claudia, Fries Thomas, Rapp Kilian

机构信息

Abteilung für Geriatrie, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376, Stuttgart, Deutschland.

Institut für Epidemiologie und Med. Biometrie, Universität Ulm, Ulm, Deutschland.

出版信息

Z Gerontol Geriatr. 2024 Aug;57(5):389-394. doi: 10.1007/s00391-023-02271-3. Epub 2024 Jan 12.

Abstract

BACKGROUND

In Germany, different models of orthogeriatric co-management have been implemented in certified geriatric trauma centers. So far, it is not clear how the different models are implemented and what influence the certification has on the structures and processes within the centers. The present study examined the extent of cooperation between surgery and geriatrics and if the quality of care had changed since the certification of the centers.

METHODS

In this study 4 guided focus group interviews (FGI) were conducted in different teams of certified geriatric trauma centers in 3 federal states with 16 participants. To specify the content of the FGI, two additional interviews were conducted with system auditors. Both types of interview were analyzed by content analysis.

RESULTS

The certification supported the implementation of structures and processes in the different orthogeriatric models; however, the quality of care and cooperation between surgery and geriatrics depends on the spatial proximity and the orthogeriatric care model in the geriatric trauma centers. Simultaneously, challenges in the area of geriatric syndromes and the recruitment of skilled staff became relevant.

DISCUSSION

The results can help to reflect processes in the certified geriatric trauma centers and to treat geriatric syndromes more effectively. In the future, the challenge will be to establish geriatric care under the existing shortage of skilled staff.

摘要

背景

在德国,认证的老年创伤中心已实施了不同模式的骨科-老年医学联合管理。到目前为止,尚不清楚不同模式是如何实施的,以及认证对中心内部的结构和流程有何影响。本研究调查了外科与老年医学之间的合作程度,以及自中心认证以来护理质量是否发生了变化。

方法

在本研究中,在3个联邦州的认证老年创伤中心的不同团队中进行了4次引导式焦点小组访谈(FGI),共有16名参与者。为了明确FGI的内容,还与系统审计员进行了另外两次访谈。两种类型的访谈均通过内容分析进行分析。

结果

认证支持了不同骨科-老年医学模式中结构和流程的实施;然而,护理质量以及外科与老年医学之间的合作取决于老年创伤中心的空间 proximity 和骨科-老年医学护理模式。同时,老年综合征领域的挑战和熟练工作人员的招聘变得至关重要。

讨论

研究结果有助于反映认证老年创伤中心的流程,并更有效地治疗老年综合征。未来,面临的挑战将是在现有熟练工作人员短缺的情况下建立老年护理服务。

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