College for Geriatrics

1. State of the Art2. Projects’ results

Jean-Pierre Baeyens on behalf of the College for Geriatrics

J.P.Baeyens et al. BVGG 2000

State of the art (1)

• Peer review 2000: 103/160 geriatric units– 13 admissions/bed/year (median)– 50% admissions from private home– 46% home discharge– median age = 82 yrs– length of stay 22 days– median occupation rate 90%– multidisciplinary team

State of the art (2)

• 21 formation centers

• 37 fellow places available

http://www.health.fgov.be/AGP/fr/professions/medecins/maitre_de_stage/specialites/geria.htm

College ’s projects

• 2000: peer review

• 2001: nutrition

• 2002: continence, emergency, radiotherapy

• 2003: BMDS, AGGIR, ...

• collaborations with the Colleges for:– radiotherapy– nephrology– emergency medicine

Nutrition program 2001

OUTCOMES OF CONTINUOUS PROCESS

IMPROVEMENT OF NUTRITIONAL CARE PROGRAM

AMONG GERIATRIC UNITS IN BELGIUM

Nutrition program 2001

Methodology: 2 phases

Observation• comprehensive

geriatric assessment and MNA

• routine nutrition

Intervention• comprehensive

geriatric assessment and MNA

• « Flow Chart»• « Meals on Wheels »

approach

0 3 6 months

±Std. Dev.

±Std. Err.

Mean

Phase 1 Phase 2

STA

Y (

da

ys

)

0

10

20

30

40

50

60

Nutrition program 2001

Conclusions

• high prevalence of malnutrition among geriatric hospitalized patients

• significant decreased hospitalization stay during 2nd phase (confounding factors ?)

• significant increased PAB concentrations during 2nd phase

J Gerontology 2004, In Press

DRIP

Detect, Reduce, Incontinence, Programme

Thierry Pepersack on behalf of the College for Geriatrics

Continence 2002

Discussion

• 45% of incontinent patients in geriatric units• 26% of transient incontinence• functional incontinence represents more than

half of the chronic situations• incontinence is associated with:

– high length of stay– high proportion of demented patients

2003 - 2004Belgian Minimal Geriatric

Screening Tools

BMGST

Rationale

• the belgian geriatric program is associated with the obligation of continuous registration of quality variables

• the ministry intends to ask us this registration

• the College for Geriatrics and the Belgian Society for Gerontology and Geriatrics think it would be better to choose ourselves these variables among the comprehensive geriatric assessment

Worksheet

• Part I: 2003 - questionnaire about Comprehensive Geriatric Assessment

• Part II: 2004 - consensus conference "Belgian Minimum Geriatric Screening Tools »

• Part III: 2005 - topics choice

www.geriatrie.be

Part I

Belgian Minimum Geriatric Screening Tools

for Comprehensive Geriatric Assessment

College for Geriatrics

Results

• 59 questionnaires• acute and subacute G beds

Comprehensive Geriatric Assessment

• ADL• IADL• risk of falling• cognition• depression

• social• nutrition• pain• QOL

already used proposed for BMGS

Conclusions Part I

quality of questionnaire

not enough CGA

lack of uniformity CGA

~ no consensus

response rate

geriatricians : interested in CGA

transparency of geriatric units

www.geriatrie.be

Part II

2004Consensus Conference

"Belgian Minimum Geriatric Screening Tools »

College for Geriatrics

Working groups

ADL-IADL P De Vriendt, G Dargent, C Swine

Mobility JP Baeyens , Ghesquière

CognitionM Lambert , E Gorus, C Sachem

DepressionA Velghe, Th Pepersack

SocialJP Baeyens, H Vandekerkhof

NutritionT Pepersack, H Daniels,J Pétermans, C Gazzotti

PainN Vandennoorgate, A Pepinster

FrailtyC Swine, G Dargent, P De Vriendt

www.geriatrie.be

www.geriatrie.be

Part III

2005Topics choice

College for Geriatrics

Results

52

51

38

32

26

23

16

12

0 10 20 30 40 50 60

mobility

cognition

frailty

ADL

Nutrition

Social

Depression

Pain

Priorities

• geriatric programme• programmation of beds• adapted financial ressources• alternative services

– day hospital– inpatients geriatric consultation service

(multidisciplinary)– for geriatric problems (confusion, denutrition, falls,

incontinence, etc.)

College ’s role

Objectives• quality• partnership• « education » and

awareness campaign • promotion of a broader

health concept

Ressources• advisory board• scientific society• surveys (nutrition,

continence, SEGA)• comprehensive geriatrics

focused on:- maintenance of function

and comfort- presence of satisfactory

support systems