Elder-friendly Approaches to the Surgical Environment (EASE) Study

University of Alberta723 enrolled

Overview

The aim of this study is to examine the impact implementing an elder-friendly surgical unit has on post-operative complications, mortality and quality of life for patients ≥ 65 years old who have undergone emergency surgical care.

The investigators hypothesize that the elder-friendly surgical unit will reduce in-hospital complications and mortality in a cost-effective manner, for this at risk population. Specific elder-friendly interventions include: 1. Locate all elderly surgical patients on one nursing unit 2. Interdisciplinary team-based care 3. Elder-friendly evidence-informed practices including: comfort rounds with early mobilization, delirium prevention/management, optimal nutrition and prevention of post-operative complications 4. Early and interdisciplinary discharge management This is a prospective, before-after study with a concurrent control group. Four senior patient groups will be followed:

Study Type

OBSERVATIONAL

Enrollment

723

Conditions

General Surgery

Interventions

Elder-Friendly Surgical UnitOTHER

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All patients \> 65 years old admitted for Acute care and Emergency Surgery * Received acute abdominal surgery Exclusion Criteria: * Elective general surgery cases * Nursing home resident requiring full nursing care \[dependency in 3 or more activities of daily living \] * Palliative surgery \[surgery with the primary intention of improving quality of life or relieving symptoms caused by advancing non-curative disease\] * Multi-system trauma * Patients from out of province or transferred from another inpatient service or hospital

Locations (2)

Foothills Medical Center, Acute Care Emergency Surgical Services

Calgary, Alberta, Canada

University of Alberta Hospital, Acute Care and Emergency Surgery Service

Edmonton, Alberta, Canada

Outcomes

Primary Outcomes

Post-Operative complications

Includes a) intensive care unit admission (includes respiratory failure, cardiac arrest or septic shock), b) vascular complications (myocardial infarction, stroke, deep venous thrombosis, pulmonary embolism), c) serious infections (pneumonia, intra-abdominal abscess, urinary tract infection, deep wound infection or infected decubitus ulcer) or d) protracted delirium (≥48 hours)

Time frame: During initial in-hospital stay (0-12 weeks on average)

Death

Time frame: During initial in-hospital stay (0-12 weeks on average)

Secondary Outcomes

Post-discharge complications or health-events requiring re-admission

Time frame: Within 30 days post-discharge

Cost per quality-adjusted life year

Both direct and indirect study participant costs

Time frame: 6 months post-discharge

Data from ClinicalTrials.gov

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