title: A formative evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic.
abstract: The number of older adults with multiple complex comorbidities and frailty is expected to increase dramatically in the coming decades, which will necessitate a concomitant increase in the need for skilled clinicians who are able to manage complex geriatric needs. Many physicians, however, lack the required formal training, often leading to long wait-lists for specialist clinics. Yet, clinics led by non-physician professionals specialising in geriatric care could decrease these delays. This article describes the development and evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic (Inter-D Clinic). A combination of semi-structured clinician interviews, post-clinic follow-up phone calls, satisfaction surveys, and information from the hospital workload management system served as data sources for this formative programme evaluation. Between January 2013 and December 2014, 293 patients were seen in the clinic with the majority being referred for either memory issues (49%) or functional decline (35%). The clinic assessment frequently uncovered other issues, which led to guidance around falls prevention, improved nutrition, medication management, and referrals to available community supports. Both patients and referring physicians were very satisfied with this model of care, which is likely transferable to other locations provided the needed clinical expertise and community support services are available.
authors.affiliation: a Lawson Health Research Institute , London , Ontario , Canada.|b Faculty of Health Sciences , Western University , London , Ontario , Canada.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Hansen
authors.affiliation: c St. Joseph's Health Care London , Parkwood Institute , London , Ontario , Canada.
authors.forename: Cheryl
authors.initials: C
authors.lastname: McDonald
authors.affiliation: a Lawson Health Research Institute , London , Ontario , Canada.|c St. Joseph's Health Care London , Parkwood Institute , London , Ontario , Canada.
authors.forename: Sue
authors.initials: S
authors.lastname: O'Hara
authors.affiliation: c St. Joseph's Health Care London , Parkwood Institute , London , Ontario , Canada.
authors.forename: Leslie
authors.initials: L
authors.lastname: Post
authors.affiliation: c St. Joseph's Health Care London , Parkwood Institute , London , Ontario , Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Silcox
authors.affiliation: a Lawson Health Research Institute , London , Ontario , Canada.|d Schulich School of Medicine and Dentistry , Western University , London , Ontario , Canada.
authors.forename: Iris A
authors.initials: IA
authors.lastname: Gutmanis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D005853:Geriatrics / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000458:organization & administration*; D009788:Occupational Therapy / Q000458:organization & administration; D017060:Patient Satisfaction; D059825:Physical Therapists / Q000458:organization & administration; D012947:Social Work / Q000458:organization & administration
keywords: Geriatric assessment; interprofessional care; nurse practitioner-led; older adults; practice