SHM Converge Scientific Abstract ePoster Gallery-Geriatric Trauma Hospitalist Service: Efficiencies Over Time

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This retrospective study evaluated whether a geriatric trauma (GT) hospitalist care model improved efficiency over time at a Level 1 trauma center. From 2016–2021, 3,300 GT patients aged 65+ were admitted, including 984 with femur fractures. The service uses hospitalists with surgical consultation to reduce trauma-surgery workload and improve throughput.<br /><br />To support this model, the hospital implemented annual geriatric trauma education conferences beginning in 2018, focused on topics such as VTE prophylaxis, preoperative optimization, delirium, and postoperative complications. Evidence-based order sets for pain management and delirium prevention were also introduced, and dedicated GT hospitalists gained ATLS certification and participated in trauma quality conferences.<br /><br />Overall, admissions increased more than threefold over the study period, from 322 in 2016 to 1,040 in 2021. Despite this rise, average length of stay remained stable at about 6.5 days for all GT patients and stayed stable for femur fracture patients as well. Average age was 81 years and injury severity score was 10.<br /><br />Resource use improved, especially pharmacy costs. Direct pharmacy costs decreased across all GT admissions over time, with a similar trend among femur fracture patients. For femur fractures, discharge to skilled nursing facilities declined, while discharge to inpatient rehabilitation increased, and discharge home remained relatively stable. Across all GT patients, discharge patterns stayed generally consistent, with 68–71% going to SNF or IPR.<br /><br />The authors conclude that targeted education, standardized order sets, and a dedicated physician cohort enabled the hospital to absorb a major increase in geriatric trauma admissions without worsening length of stay, while also reducing pharmacy costs and maintaining stable discharge outcomes.

Asset Subtitle

Gina Khraish

Meta Tag

Author List Amee Amin, Andreea S. Xavier, Gina Khraish, Thaddeus J. Puzio

Category Research

Concept Hospitalist-Led Care Model

Concept Geriatric Trauma Care

Concept Length of Stay

Concept Discharge Disposition

Concept Trauma Service Efficiency

Distinguished Non-Finalist

Presenter Organization McGovern Medical School

Presenting Author Gina Khraish

Track Geriatrics

Keywords

geriatric trauma

hospitalist care model

Level 1 trauma center

length of stay

femur fractures

pharmacy costs

delirium prevention

VTE prophylaxis

standardized order sets

discharge disposition

Hospitalist-Led Care Model

Geriatric Trauma Care

Length of Stay

Discharge Disposition

Trauma Service Efficiency