Implementing a perioperative medicine for older people undergoing surgery (POPS) service: A guide for clinical leaders

Margot Elizabeth Lodge; Jugdeep Dhesi; Nadine Elizabeth Andrew; Velandai Srikanth; Darshini Rebecca Ayton; Chris Moran

doi:10.1111/ajag.13376

Implementing a perioperative medicine for older people undergoing surgery (POPS) service: A guide for clinical leaders

Australas J Ageing. 2024 Oct 4. doi: 10.1111/ajag.13376. Online ahead of print.

Authors

Margot Elizabeth Lodge^{1

2

3}, Jugdeep Dhesi^{4

5}, Nadine Elizabeth Andrew^{1

2}, Velandai Srikanth^{1

2

6}, Darshini Rebecca Ayton^{1

7

8}, Chris Moran^{1

2

3

6

8}

Affiliations

¹ National Centre for Healthy Ageing, Melbourne, Victoria, Australia.
² Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
³ Alfred Health, Melbourne, Victoria, Australia.
⁴ Guy's and St Thomas' NHS Foundation Trust, London, UK.
⁵ King's College London, London, UK.
⁶ Peninsula Health, Frankston, Victoria, Australia.
⁷ Health and Social Care Unit, Monash University, Melbourne, Victoria, Australia.
⁸ School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

PMID: 39367627
DOI: 10.1111/ajag.13376

Abstract

Objective: This study aimed to translate previous implementation science research describing the implementation of perioperative medicine for older people undergoing surgery (POPS) services into a format that is comprehensible and relevant to clinical leaders contemplating implementing a POPS service.

Methods: We conducted a multistage expert end-user review process to design a POPS implementation guide. Our expert research team created a draft POPS service implementation guide using previous implementation science research that described the core elements and implementation of a POPS service. Next, we invited multidisciplinary (allied health, anaesthetics, geriatric medicine, nursing and surgery) clinical leaders in perioperative medicine (n = 12) from five contextually different health services to review the guide. These clinical leaders then participated in two rounds of review and refinement of the implementation guide.

Results: The first draft of the POPS service implementation guide was reviewed by clinical leaders (n = 4) with participants querying implementation science-based language and concepts, the format of the guide and its practical use. We revised the guide accordingly, and the next draft was reviewed by the second group of clinical leaders (n = 8). Feedback from the second group review was supportive of the guide's comprehensibility and relevance, and only minor changes were made to the final version of the POPS service implementation guide.

Conclusions: We used an implementation science-based approach to create a POPS service implementation guide that is comprehensible and relevant to clinical leaders in perioperative care. The next steps are to use the guide and assess its utility to support implementation of a POPS service.

Keywords: geriatric assessment; perioperative care.