AGS and ADGAP co-management plan for hip fractures sees geriatrics mending more than bones

With support from the John A. Hartford Foundation of New York, the American Geriatrics Society (AGS) and the Association of Directors of Geriatric Academic Programs (ADGAP) will develop a national dissemination plan for an innovative program to improve care for older adults hospitalized with hip fractures. The interdisciplinary geriatrics-orthopedics co-management intervention positions geriatrics professionals as co-leaders in the pre- and post-operative management of older adults with fragility fractures. With geriatrics principles at its core, the program holds promise for improving person-centered care outcomes and decreasing healthcare spending.

"Addressing risk factors for harmful events that can occur when vulnerable older adults are hospitalized reduces complications and enhances function--two goals at the heart of geriatrics care," explains Richard W. Besdine, MD, Professor of Medicine and Public Policy at Alpert Medical School and the School of Public Health of Brown University, and the project's principal investigator (PI). "With the generous support of the John A. Hartford Foundation, we'll be able to encourage national uptake of this co-management intervention and ultimately train an array of health professionals to employ geriatrics principles that can keep elders healthy, independent, and active for as long as possible."

Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation added, "To make large-scale practice change in the care of older Americans, the John A. Hartford Foundation wants to help spread models like geriatrics-orthopedics co-management that have evidence of improved outcomes and reduced costs. We believe that this work addresses an important need and is a great opportunity to improve the lives of older people while reducing wasteful spending."

The work conducted by AGS and ADGAP will include engaging potential sites for the co-management intervention and refining specific models and tools to integrate geriatrics and orthopedics care delivery. With additional support under a possible second phase of collaboration, the AGS and ADGAP ultimately will create a sustainable business enterprise to market and disseminate the co-management intervention to more than 100 leading health facilities, systems, and academic training hospitals to be tapped as "early adopters" over the next three years.

Hip fractures, which hospitalize an estimated 258,000 individuals annually and could impact some 500,000 patients by 2040, are a serious cause of disability, decreased quality of life, and even death among older adults. Many such fractures result from falls, which affect older people in particular because of weaker bones, poor vision, and balance problems that can come with aging.

But as Dr. Besdine's co-PI, Daniel Mendelson, MD--Professor of Medicine, Division of Geriatrics at the University of Rochester School of Medicine & Dentistry and Associate Chief of Medicine at Highland Hospital--observes, the results of this co-management intervention could be game-changing. "A truly interdisciplinary, coordinated approach that involves geriatrics specialists in each step of caring for older people with osteoporotic fractures reduces complications, shortens hospital stays, decreases costs, and improves mortality," Dr. Mendelson noted.

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Institutions interested in participating in the geriatrics-orthopedics co-management program can contact the AGS for additional information (info.amger@americangeriatrics.org; 212-308-1414).

Working collaboratively with the American Geriatrics Society (AGS), the Association of Directors of Geriatric Academic Programs (ADGAP) is committed to advancing academic geriatrics programs and supporting academic geriatrics program directors in order to benefit and aid patient care, research, and teaching programs in geriatric medicine within accredited medical schools located in the United States. ADGAP has built and fostered new methods of facilitating the development of leadership skills among academic geriatricians and has provided an ongoing forum for program directors and leaders in academic geriatrics to discuss the wide variety of issues that they encounter. For more information, visit adgap.americangeriatrics.org.

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Its more than 6,200 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit americangeriatrics.org.

The John A. Hartford Foundation is a private philanthropy working to improve the health of older Americans. After three decades of championing research and education in geriatric medicine, nursing, and social work, today the Foundation pursues opportunities to put geriatrics expertise to work in all health care settings. This includes advancing practice change and innovation, supporting team-based care through interdisciplinary education of all health care providers, supporting policies and regulations that promote better care, and developing and disseminating new evidence-based models that deliver better, more cost-effective health care. The Foundation was established by John A. Hartford. Mr. Hartford and his brother, George L. Hartford, both former chief executives of the Great Atlantic & Pacific Tea Company, left the bulk of their estates to the Foundation upon their deaths in the 1950s. For more information, visit http://www.jhartfound.org.