Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators
Abstract Background With a shortage of geriatricians and an aging population, strategies are needed to optimise the distribution of geriatricians across different healthcare settings (acute care, rehabilitation and community clinics). The perspectives of knowledge users on staffing geriatricians in...
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| Language: | English |
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BMC
2025-01-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-05691-5 |
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| author | Eric Kai-Chung Wong Andrea C. Tricco Wanrudee Isaranuwatchai David M. J. Naimark Sharon E. Straus Joanna E. M. Sale |
| author_facet | Eric Kai-Chung Wong Andrea C. Tricco Wanrudee Isaranuwatchai David M. J. Naimark Sharon E. Straus Joanna E. M. Sale |
| author_sort | Eric Kai-Chung Wong |
| collection | DOAJ |
| description | Abstract Background With a shortage of geriatricians and an aging population, strategies are needed to optimise the distribution of geriatricians across different healthcare settings (acute care, rehabilitation and community clinics). The perspectives of knowledge users on staffing geriatricians in different healthcare settings are unknown. We aimed to understand the acceptability and feasibility (including barriers and facilitators) of implementing a geriatrician-led comprehensive geriatric assessment (CGA) in acute care, rehabilitation, and community clinic settings. Methods A qualitative description approach was used to explore the experience of those implementing (administrative staff), providing (healthcare providers), and receiving (patients/family caregivers) a geriatrician-led CGA in acute care, rehabilitation and community settings. Semi-structured interviews were conducted in Toronto, Canada. The theoretical domains framework and consolidated framework for implementation research informed the interview guide development. Analysis was conducted using a thematic approach. Results Of the 27 participants (8 patients/caregivers, 9 physicians, 10 administrators), the mean age was 53 years and 14 participants (52%) identified as a woman (13 [48%] identified as a man). CGAs were generally perceived as acceptable but there was a divergence in opinion about which healthcare setting was most important for geriatricians to staff. Acute care was reported to be most important by some because no other care provider has the intersection of acute medicine skills with geriatric training. Others reported that community clinics were most important to manage geriatric syndromes before hospitalization was necessary. The rehabilitation setting appeared to be viewed as important but as a secondary setting. Facilitators to implementing a geriatrician-led CGA included (i) a multidisciplinary team, (ii) better integration with primary care, (iii) a good electronic patient record system, and (iv) innovative ways to identify patients most in need of a CGA. Barriers to implementing a geriatrician-led CGA included (i) lack of resources or administrative support, (ii) limited team building, and (iii) consultative model where recommendations were made but not implemented. Conclusions Overall, participants found CGAs acceptable yet had different preferences of which setting to prioritise staffing if there was a shortage of geriatricians. The main barriers to implementing the geriatrician-led CGA related to lack of resources. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-3f2d2c8d64ab47f29d9b145f8f1c6c19 |
| institution | Kabale University |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj-art-3f2d2c8d64ab47f29d9b145f8f1c6c192025-01-19T12:38:05ZengBMCBMC Geriatrics1471-23182025-01-0125111410.1186/s12877-025-05691-5Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administratorsEric Kai-Chung Wong0Andrea C. Tricco1Wanrudee Isaranuwatchai2David M. J. Naimark3Sharon E. Straus4Joanna E. M. Sale5Faculty of Medicine, University of TorontoInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of TorontoInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of TorontoFaculty of Medicine, University of TorontoFaculty of Medicine, University of TorontoInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of TorontoAbstract Background With a shortage of geriatricians and an aging population, strategies are needed to optimise the distribution of geriatricians across different healthcare settings (acute care, rehabilitation and community clinics). The perspectives of knowledge users on staffing geriatricians in different healthcare settings are unknown. We aimed to understand the acceptability and feasibility (including barriers and facilitators) of implementing a geriatrician-led comprehensive geriatric assessment (CGA) in acute care, rehabilitation, and community clinic settings. Methods A qualitative description approach was used to explore the experience of those implementing (administrative staff), providing (healthcare providers), and receiving (patients/family caregivers) a geriatrician-led CGA in acute care, rehabilitation and community settings. Semi-structured interviews were conducted in Toronto, Canada. The theoretical domains framework and consolidated framework for implementation research informed the interview guide development. Analysis was conducted using a thematic approach. Results Of the 27 participants (8 patients/caregivers, 9 physicians, 10 administrators), the mean age was 53 years and 14 participants (52%) identified as a woman (13 [48%] identified as a man). CGAs were generally perceived as acceptable but there was a divergence in opinion about which healthcare setting was most important for geriatricians to staff. Acute care was reported to be most important by some because no other care provider has the intersection of acute medicine skills with geriatric training. Others reported that community clinics were most important to manage geriatric syndromes before hospitalization was necessary. The rehabilitation setting appeared to be viewed as important but as a secondary setting. Facilitators to implementing a geriatrician-led CGA included (i) a multidisciplinary team, (ii) better integration with primary care, (iii) a good electronic patient record system, and (iv) innovative ways to identify patients most in need of a CGA. Barriers to implementing a geriatrician-led CGA included (i) lack of resources or administrative support, (ii) limited team building, and (iii) consultative model where recommendations were made but not implemented. Conclusions Overall, participants found CGAs acceptable yet had different preferences of which setting to prioritise staffing if there was a shortage of geriatricians. The main barriers to implementing the geriatrician-led CGA related to lack of resources. Clinical trial number Not applicable.https://doi.org/10.1186/s12877-025-05691-5GeriatricianQualitative studyComprehensive geriatric assessmentHealthcare settingStaffingImplementation science |
| spellingShingle | Eric Kai-Chung Wong Andrea C. Tricco Wanrudee Isaranuwatchai David M. J. Naimark Sharon E. Straus Joanna E. M. Sale Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators BMC Geriatrics Geriatrician Qualitative study Comprehensive geriatric assessment Healthcare setting Staffing Implementation science |
| title | Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators |
| title_full | Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators |
| title_fullStr | Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators |
| title_full_unstemmed | Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators |
| title_short | Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators |
| title_sort | perspectives on which health settings geriatricians should staff a qualitative study of patients care providers and health administrators |
| topic | Geriatrician Qualitative study Comprehensive geriatric assessment Healthcare setting Staffing Implementation science |
| url | https://doi.org/10.1186/s12877-025-05691-5 |
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