Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Prospective Multicenter Cohort Study to Evaluate the Benefit of the Geriatric Fracture Center (GFC) Concept
Brief Summary: The study will assess patients with at least one major AE related to treatment / hospitalization / immobilization in the Geriatric Fracture Center (GFC) group compared to the usual care group.


Options:
A: Inclusion Criteria:

* Inclusion on cluster level requires the written agreement to participate form the hospital management, the medical head of the division and the head nurse
* Next to this, they have to agree that they will not develop and implement a care pathway for COPD- exacerbation of PFF within the time frame of the study when randomized in the control group
* Finally, the participating hospitals need an expected volume of more than one hundred COPD-exacerbation or PFF patients annually.
* To have a comparable sample across all clusters, the following inclusion criteria on individual level are set:

  1. All professionals that according to the medical head of the division and head nurse are member of the interprofessional team caring for COPD-exacerbation or PFF patients from admission until discharge out of the acute hospital ward
  2. To be part of the interprofessional care team is further conceptualized as being part of the group of clinicians and staff who have a shared clinical purpose and direct care responsibilities for the respective patient group during the set time period
  3. All individual participants need to be member of the team during one specific week, where patients are being followed for the two other trials of the EQCP-project (8). This specific week is chosen by the study coordinator and can be defined as an average week, with normal staff ratios
  4. Because we want to study interprofessional teamwork, each cluster is asked to minimally include the orthopedic surgeons/pneumologists, head nurse, nurses, physiotherapists and social workers in their sample. Based on their own judgment, the chief medical doctor, in consensus with the head nurse, can decide to include other professional groups in their sample
  5. In some hospitals COPD-exacerbation or PFF patients are being admitted at multiple nursing wards, e.g. due to capacity problems or other organizational issues. If that is the case, then the clusters are asked to only include these team members that are working on the ward where the respective patient groups are being admitted most frequently.

Exclusion Criteria:

* All team members that are not working (e.g. on leave) during the chosen week
* All team members who are only temporarily part of the team (e.g. student nurses in training).
B: Preoperative Inclusion Criteria:

* Age ≥ 70 years
* Geriatric patients with hip fractures Treated either with oOsteosynthesis or oEndoprosthesis
* Ability of the patient or assigned representative to understand the content of the patient information / Informed Consent Form
* Signed and dated Institutional Review Board (IRB) / Ethics Committee (EC)-approved written informed consent

Preoperative Exclusion Criteria:

* Recent history of substance abuse (ie, recreational drugs, alcohol) that would preclude reliable assessment
* Prisoner
* Participation in any other medical device or medicinal product study within the previous month that could influence the results of the present study
C: Inclusion Criteria:

* Admitted to Barnes Extended Care nursing home
* Acute disablement
* (criterion dropped) Clinically depressive symptoms, including a score of 15 or greater on the Hamilton Depression Rating Scale (HAM-D) and depressed mood or anhedonia present more days than not since the fracture

Exclusion Criteria:

* Unable to provide informed consent due to dementia and severe persistent delirium
* Inability to cooperate with the protocol
* Cardiac or other medical instability that would preclude carrying out high intensity exercises
* Language, visual, or hearing barriers to participation
* Presence of pelvic fractures that do not involve the proximal femur
* Presence of metastatic cancer, including cancer that causes a pathological fracture
* Bilateral acute hip fractures
* Lifetime psychosis or mania
* Alcohol or substance dependence within 6 months, or current (prior to hip fracture) alcohol or substance abuse
D: Inclusion Criteria:

* Inclusion criteria on cluster level are:

  1. Written agreement to participate in the study;
  2. Agreement that a care pathway for PFF will not be developed and used within the time frame of the study when randomized in the control group.
* Inclusion criteria on patient level are:

  1. Written informed consent;
  2. All consecutive admissions with PFF;
  3. Minimum age of 65 years;
  4. Closed fracture;
  5. Eligible for surgical intervention;
  6. ASA-score of 1, 2 or 3;
  7. Each patient was included only once in the study at initial hospitalization, even if the patient has been hospitalized more than once.

Exclusion Criteria:

* Exclusion criteria on patient level:

  1. Patients with severe dementia (DSM IV);
  2. Bone metastatic diseases (pathologic fractures);
  3. Second fracture on the same hip (i.e. peri-prosthetic fracture)

Inclusion criteria on multidisciplinary team level:

1. Team members are involved in direct patient care responsibilities for PFF;
2. Minimum representation of the core disciplines according to PFF literature;

Answer: B