Problem-solving to improve patient care: Geriatric Trauma Service forms to address growing needs

The trailblazing collaboration means that older trauma patients receive care which better responds to their unique needs, said geriatrician Dr Margot Lodge.

“The Geriatric Trauma Service is staffed by geriatricians, so we bring our expertise in the care of older people, and all the complexities that come with that, in order to help provide the best possible care for older patients,” says Dr Lodge.

“We know older people may be living with frailty and often have additional issues on top of their traumatic injuries, so we work to provide multidisciplinary care with the trauma doctors, nurses, pharmacists and allied health team.”

The introduction of the specialised service initially came as Deputy Director of Trauma A/Prof Joseph Mathew recognised increasing rates of older patients being admitted following trauma.

“The numbers of injured older patients aged over-65 has steadily increased, and they now make up one-in-three of our major trauma admissions,” A/Prof Mathew said. “Low falls are now one of the most common causes of trauma, and the increase inspired us to do something about this and work towards improving the overall care of these patients.”

That number of trauma admissions due to falls from standing height spiked in FY 2022-23, with an increase of over 20 per cent compared with the previous financial year.

Having recognised the growing problem and, as Dr Lodge describes, how “one size doesn’t fit all” for healthcare – the Alfred’s Geriatric Trauma Service was born.

One year on from its launch in early February 2023, the service has now supported more than 550 patients and successfully improved patient outcomes while decreasing lengths of stay.

This, Dr Lodge suggests, is largely thanks to the service’s comprehensive approach to care that stands out as potentially the first of its kind in Australasia.

“The model we've developed recognises that the trauma service and the geriatric medicine team each bring skills that really work well together,” Dr Lodge explained. “And our two teams have a  synergy that means that we can think big picture and not just about the injuries, but about the person.”

“Our model of care means we can work in parallel and provide interdisciplinary care with all the other members of the team here at Alfred Health in a manner that I'm not aware has been replicated anywhere else.”

“I think what the Geriatric Trauma Service brings is a holistic approach to things,” says A/Prof Mathew. “So, you're not talking about just the medical components of it, you're also looking at the patients and trying to think from the patient's perspective and understand the patient’s wishes and the family’s wishes.”

“The geriatricians are able to bring that robustness, which eventually ends up with a good outcome for all aspects of patient care.”

Dr Lodge agrees, suggesting that the “person-centredness” is one of the things she loves most about geriatric medicine, and which she now applies to her work with the Geriatric Trauma Service to offer older trauma patients the best possible care from start to finish – and beyond.

“We’re involved from the get-go, so we can better know what trajectory that person is on,” Dr Lodge said. “I'm not meeting these patients towards the end of their stay and trying to catch-up to understand how they've progressed. Instead, I’m able to get to know them early in their hospital stay and understand what’s important to them, and use this to help guide their ongoing recovery.”

“Put simply, we're thinking about the end of the stay from the first day of admission, which helps to get patients home quickly and avoid the complications or the stress of being in hospital.”

Learn more about the work of the Geriatric Trauma Service team