Authors (including presenting author) :
Wong MK(1), Cheng EY(1), Tsang WY(1), Lin HC(1), Wong PW(1)
Affiliation :
(1) Geriatric Day Hospital, United Christian Hospital
Introduction :
The Geriatric Day Hospital (GDH) addresses the healthcare needs of an aging population with significant fall and fracture risks. Hong Kong epidemiological data indicates sarcopenia prevalence of 12.3% among community-dwelling elderly, escalating to 40.5% in those aged over 75 years. With the elderly population projected to constitute 31% by 2036 and approximately 6,000 annual hip fractures reported, the absence of systematic sarcopenia screening protocols necessitated intervention.
Objectives :
This quality improvement initiative aimed to establish a comprehensive sarcopenia screening program adhering to EWGSOP2 criteria, incorporating both assessment and intervention protocols. The program's primary goals encompassed early detection, implementation of individualized exercise regimens, and integration of nutritional interventions to mitigate fall risks and prevent fractures.
Methodology :
The implementation strategy comprised two distinct phases: Phase 1: Basic Screening Protocol Implementation of SARC-F questionnaire-based screening for patients aged ≥60 years with fall and hip fracture history. Physical assessment parameters included handgrip dynamometry, 6-meter walk test, and calf circumference measurements. Phase 2: Advanced Assessment Integration Integration of bioelectrical impedance analysis while maintaining Phase 1 protocols. Role delineation assigned nurses to screening and machine operation, while Patient Care Assistants facilitated positioning and equipment preparation. Staff competency development included comprehensive training on bioelectrical impedance analysis operation and digital documentation systems.
Result & Outcome :
Initial implementation phase demonstrated significant engagement with 94 referrals, achieving 77 completed SARC-F assessments. Analysis identified 20 high-risk cases (SARC-F ≥4), promptly initiating targeted interventions including exercise training and dietetic consultation. Phase 2 established refined workflow protocols and introduced bioelectrical impedance analysis equipment by December 2024. Subsequent developments included standardized workflow algorithms for sarcopenia screening, comprehensive staff training completion, competency audit implementation, and distribution of quick-reference cue cards to support daily operations. Nurses streamlined BIA report accessibility by uploading to CMS via iPad scanning for multidisciplinary team reference. Conclusion: Ongoing monitoring demonstrates successful protocol implementation with continued focus on staff competency development and outcome analysis. The establishment of standardized workflows and supporting materials has enhanced operational efficiency and staff confidence in conducting screenings. Future directions include longitudinal assessment of intervention effectiveness, protocol refinement based on accumulated data, and regular competency reassessment to maintain high-quality screening standards.
