The neurosurgery-geriatric service: a mixed-methods evaluation of a novel integrated model of care for older neurosurgical patients

BACKGROUND: In response to an ageing population, our institution established a consultant-led, neurosurgery-geriatric service for neurosurgical patients. This paper highlights our experience with this model of care through staff feedback and service review. METHODS: A mixed-methods evaluation was conducted, with the quantitative phase involving a review of a prospectively collected database of neurosurgery-geriatric reviews. The qualitative phase involved interviewing multidisciplinary team members, asking: 'What areas do you think the service should focus on to improve care of elderly neurosurgery patients?' RESULTS: 57 patient reviews were undertaken across 10 consultant-led ward rounds. Additional medical needs were identified in 96% of reviews (n = 55). Further investigations were requested in 65% (n = 37), while 67% (n = 38) received additional interventions. Notably, 53% (n = 30) had medications altered. Thematic analysis of staff interviews identified four themes: provision of holistic care; medication review and patient safety; interdisciplinary communication and staff education. Most staff reported that these areas were being effectively addressed by the service. CONCLUSIONS: Our results highlight the neurosurgery-geriatric service as a valuable innovation for enhancing patient care, and optimising the management ofelderly patients by addressing identified themes. Future analysis will be undertaken to assess reduced length of stay and increased residential discharges.