Abstract
Introduction:
As neurosurgical procedures are increasingly performed on older patients, there is a growing need to incorporate geriatric care to optimise clinical outcomes. In response, the neurosurgical and geriatric teams at our institution collaborated and launched an in-reach service for elderly patients on neurosurgical wards in January 2025.
This project aimed to identify staff perceptions around how the new service could benefit neurosurgical patients and identify areas for improvement.
Methods:
This qualitative study involved interviewing 15 colleagues across the Neurosurgical multi-disciplinary team (MDT). The question posed was “What areas do you think the service should focus on to improve the care of elderly neurosurgery patients?”. Responses were recorded, transcribed and coded to facilitate a thematic analysis.
Results:
All members of the MDT felt the service would benefit the care of older neurosurgical patients. Analysis of the responses identified 5 main themes: managing medical complexity, providing holistic care, medicines optimisation, improved inter-disciplinary communication and staff education.
Examples of staff comments included:
- “Sometimes with a neurosurgical head, we maybe don’t think about other issues we need to be thinking about.”
- “I have noticed when they have the rounds, there is a bit more of a focus on looking at the medication, especially medication that isn’t solely related to neurosurgery. I think it’s useful that they’re looking at chronic conditions as well as acute presentations”.
However, very few comments mentioned the potential role of Geriatric medicine in assisting patient rehab.
Conclusions:
The results of our study highlight that staff have positive perceptions towards the introduction of the Neurosurgery-Geriatric in-reach service and feel it can benefit the care of older neurosurgical patients. The identified themes mostly align with the principles of comprehensive geriatric assessment. The comments also identified the need to highlight the potentially beneficial role of Geriatric medicine in patient rehabilitation.