ABSTRACT
In the co-management model for hip fracture, also known as the Rochester Model of Care, the patient is technically admitted to the orthopaedic surgery service but co-managed by both orthopaedics and geriatrics, meaning that the patient is seen by both teams every day. This chapter focuses on the Rochester Model of co-management developed to treat hip fracture patients. Given the multiple comorbidities and propensity for poor outcomes in geriatric hip fracture patients, the involvement of geriatricians is desirable to assist with medical management. Standard orders address all important topics including pain assessment and management, use of beta blockers, thromboembolic prophylaxis, urinary catheter use and rehabilitation. The American College of Cardiology and American Heart Association have published guidelines on the perioperative management of cardiac patients. Orthogeriatric co-management results in better satisfaction for patients and providers alike. Orthogeriatric co-management has also rarely been described in the United States.
