GIFTS: Geriatric Intensive Functional Therapy Sessions - For the older trauma patient.

BACKGROUND: Considering resources for comprehensive geriatric (GERI) care, it would be beneficial for geriatric trauma (GTP) and medical patients to be co-managed in one program focusing on ancillary therapeutics (AT): physical (PT), occupational (OT), speech (SLP), respiratory (RT) and sleep wake hygiene (SWH). This pilot describes outcomes of GTP in a hospital-wide program focused on GERI-specific AT.

METHODS: GTP and GERI patients were screened by program coordinator (PC) for enrollment at one Level II trauma center from Aug 2021-Dec 2022. Enrolled patients (EP) were admitted to trauma or medicine floors and received repetitive AT with attention to SWH throughout hospitalization and compared to similar non-enrolled patients (NEP). Excluded patients had any of the following: indication of geriatric syndrome with FRAIL 5, no frailty with FRAIL 0, comfort focused plans, or arrived from skilled care. Retrospective chart review of demographics and outcomes was completed for both EP and NEP.

RESULTS: 224 EP (28 trauma (TR)) were compared to 574 NEP (148 TR). EP showed shorter LOS (mean 3.8 vs 6.1, p = 0.0001), less delirium (3.1% vs 9.6%, p = 0.00222), less time to ambulate (13 h vs 39 h, p = 0.0005), and higher likelihood to discharge home (56% vs 27%, p < 0.0001) as compared to NEP. Median FRAIL was 3 for both groups. Medical enrolled (M-EP) ambulated the soonest at 11 average hours, compared to 23 hours for TR-EP, compared to 39 hours for NEP. Zero delirium events among TR-EP; 25% among TR-NEP, p = 0.00288.

CONCLUSION: Despite a small trauma cohort, results support feasibility to include GTP in hospital-wide programs with GERI specific AT. Mobility and cognitive strategies may improve opportunities to avoid delirium, decrease LOS and influence more frequent disposition to home.

TYPE OF STUDY: Original observational retrospective review.

LEVEL OF EVIDENCE: Level IV- Therapeutic / Care Management.