'Online' geriatric assessment procedure for older adults referred for geriatric assessment during an acute care episode for consideration of reliability of triage decisions

BMC Geriatrics

Study Protocol

Richard Wootton¹  Melinda Martin-Khan²  Lucy Dakin²  Len Gray²  Steven Counsell³  Helen Edwards⁴ 

[1] Centre for Online Health, University of Queensland, Level 3, Foundation Building, Royal Children's Hospital, 4029, Herston, Australia;Centre for Research in Geriatric Medicine, University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, Ipswich Road, QLD 4102, Woolloongabba, Australia;Indiana University School of Medicine, 1001 West 10th Street, OPW-M20046202, Indianapolis, Indiana, USA;School of Nursing and Midwifery, Queensland University of Technology, Victoria Park Road, QLD 4059, Kelvin Grove, Australia;

关键词: Residential Care;    Comprehensive Geriatric Assessment;    Triage Decision;    Discharge Destination;    Online Assessment;   

DOI  :  10.1186/1471-2318-12-10

 received in 2011-10-03, accepted in 2012-03-20,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundComprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed "online" in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional "live" consultations.Methods/DesignThe study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. "live"). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures.DiscussionIf the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance.Trial registrationTrial registration number: ACTRN12611000936921

【 授权许可】

Unknown   
© Gray et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.