1. College for Geriatrics 1. State of the Art 2. Projects results Jean-Pierre Baeyens on behalf of the College for Geriatrics

2. J.P.Baeyens et al. BVGG 2000 State of the art (1) Peer review 2000: 103/160 geriatric units –13 admissions/bed/year (median) –50% admissions from private home –46% home discharge –median age = 82 yrs –length of stay 22 days –median occupation rate 90% –multidisciplinary team

3. State of the art (2) 21 formation centers 37 fellow places available http://www.health.fgov.be/AGP/fr/professions/medecins/maitre_de_stage/specialites/geria.htm

4. College s projects 2000: peer review 2001: nutrition 2002: continence, emergency, radiotherapy 2003: BMDS, AGGIR,... collaborations with the Colleges for: –radiotherapy –nephrology –emergency medicine

5. Nutrition program 2001 OUTCOMES OF CONTINUOUS PROCESS IMPROVEMENT OF NUTRITIONAL CARE PROGRAM AMONG GERIATRIC UNITS IN BELGIUM

6. Nutrition program 2001 Methodology: 2 phases Observation comprehensive geriatric assessment and MNA routine nutrition Intervention comprehensive geriatric assessment and MNA « Flow Chart» « Meals on Wheels » approach 0 3 6 months

8. Nutrition program 2001 Conclusions high prevalence of malnutrition among geriatric hospitalized patients significant decreased hospitalization stay during 2nd phase (confounding factors ?) significant increased PAB concentrations during 2nd phase J Gerontology 2004, In Press

9. DRIP Detect, Reduce, Incontinence, Programme Thierry Pepersack on behalf of the College for Geriatrics

10. Continence 2002 Discussion 45% of incontinent patients in geriatric units 26% of transient incontinence functional incontinence represents more than half of the chronic situations incontinence is associated with: –high length of stay –high proportion of demented patients

11. 2003 - 2004 Belgian Minimal Geriatric Screening Tools BMGST

12. Rationale the belgian geriatric program is associated with the obligation of continuous registration of quality variables the ministry intends to ask us this registration the College for Geriatrics and the Belgian Society for Gerontology and Geriatrics think it would be better to choose ourselves these variables among the comprehensive geriatric assessment

13. Worksheet Part I: 2003 - questionnaire about Comprehensive Geriatric Assessment Part II: 2004 - consensus conference "Belgian Minimum Geriatric Screening Tools » Part III: 2005 - topics choice

14. www.geriatrie.be Part I Belgian Minimum Geriatric Screening Tools for Comprehensive Geriatric Assessment College for Geriatrics

15. Results 59 questionnaires acute and subacute G beds

16. Comprehensive Geriatric Assessment ADL IADL risk of falling cognition depression social nutrition pain QOL already used proposed for BMGS

17. Conclusions Part I quality of questionnaire not enough CGA lack of uniformity CGA ~ no consensus response rate geriatricians : interested in CGA transparency of geriatric units

18. www.geriatrie.be Part II 2004 Consensus Conference "Belgian Minimum Geriatric Screening Tools » College for Geriatrics

19. Working groups ADL-IADL P De Vriendt, G Dargent, C Swine Mobility JP Baeyens, Ghesquière Cognition M Lambert, E Gorus, C Sachem Depression A Velghe, Th Pepersack Social JP Baeyens, H Vandekerkhof Nutrition T Pepersack, H Daniels, J Pétermans, C Gazzotti Pain N Vandennoorgate, A Pepinster Frailty C Swine, G Dargent, P De Vriendt www.geriatrie.be

20. Part III 2005 Topics choice College for Geriatrics

21. Results

22. Priorities geriatric programme programmation of beds adapted financial ressources alternative services –day hospital –inpatients geriatric consultation service (multidisciplinary) –for geriatric problems (confusion, denutrition, falls, incontinence, etc.)

23. College s role Objectives quality partnership « education » and awareness campaign promotion of a broader health concept Ressources advisory board scientific society surveys (nutrition, continence, SEGA) comprehensive geriatrics focused on: -maintenance of function and comfort -presence of satisfactory support systems