Learning Objective #1: Describe looking into the black box: the contents of the (Dutch) Geriatric Intermediate Care Programme

Learning Objective #2: Judge how participants evaluated this research model

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Objective This study evaluates the feasibility of the Geriatric Intermediate care Programme (GIP). The GIP is a multidisciplinary model of care where nurse, GP and geriatrician share responsibility for geriatric assessment and management of care. A health problem must be presented to the GP and has to be related to one of seven defined major geriatric syndromes: cognitive, mood or mobility disorders, malnutrition, functional decline, dementia and urinary incontinence. The objective of this study is to examine the feasibility and content of the GIP.

Methods Besides patients (n=53) and carers (n=37), GPs (n=15), geriatrician (n=2) and nurses (n=6) participated in the performance of the study. Primary outcome measure was the experiences of all participants with regard to the result and the process of the intervention, which we explored by semi-structured interviews. The content of the intervention has been explored by analyses of all patient records.

Results 53 Patients were included with a mean age of 84 years old. Most patients were referred by the GP to the GIP for health problems in cognition (n=22), mood (n=13) and mobility (n=11). 34 of 37 interviewed carers had one or more positive remarks concerning the result and process. Most GPs evaluated the GIP model as contributing to the management of problems of mood (77%) and cognition (77%). The nursing interventions that were performed can be divided into five categories: (diagnostic) tests (n=101), advises (n=137), education (n=12), co-ordination of care (n=60) and other (n=20).

Conclusion The results showed that the implementation of this intervention is feasible. The specific health related requests of GPs often had a multiple character. In most cases the request contained both diagnostic and co-ordination of care elements. Diagnostic tests and patient (or carer) education were the most commonly performed interventions.