Geriatric Models of Surgical Care: A Scoping Review

ABSTRACT

Aim

To synthesise literature on hospital-based geriatric models of care for older adults undergoing surgery, examining structures, team composition, governance and nursing contributions.

Design

Scoping review.

Methods

Following JBI methodology, two reviewers independently screened articles against eligibility criteria (Population: adults ≥ 65 years, Concept: multidisciplinary geriatric surgical care model; Context: acute hospital settings), with conflicts resolved by a third reviewer. Data were extracted and charted for descriptive synthesis.

Data Sources

Six databases (CINAHL, MEDLINE, Embase, Scopus, AgeLine, Cochrane Library) searched for studies published between January 2015 and February 2025.

Results

Of 2753 records identified, 81 studies were included. Models were commonly co-managed between surgical and geriatric teams, implemented at varying surgical pathway points. Orthopaedics represented 57% of studies. Geriatricians were involved in 90% of models; 38% included advanced practice nurses or specialist gerontological nurses. Comprehensive Geriatric Assessment was used in nearly half the studies, typically preoperatively. Considerable heterogeneity existed in model design, professional roles and care settings.

Conclusion

Integrated geriatric perioperative care is expanding globally but remains limited outside orthopaedics. Research should shift from improvement projects to rigorous implementation for sustainable transformation, including nurse-led models. Critical examination is needed of whether current outcomes address comprehensive needs of older surgical patients or primarily optimise hospital flow.

Implications for the Profession and/or Patient Care

Findings highlight opportunities to expand geriatric models beyond orthopaedics and enhance nursing roles, particularly advanced practice nurses, in delivering comprehensive perioperative care for older adults.

Impact

Addressed the gap in understanding how geriatric models of surgical care are operationalised. Identified underutilisation of nursing expertise and limited expansion beyond orthopaedics. Will impact service design, policy development and clinical implementation for older surgical patients.

Reporting Method

Adhered to PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines.

Patient or Public Contribution

No patient or public involvement.

Protocol Registration

Open Science Framework Registries Network.