Table 1 Descriptive characteristics of included studies

Åberg et al. 2017 [35] Sweden

Healthcare professionals working across four geriatric wards (69 beds) providing care to older adults aged ≥ 65 years.

Total sample: 32 Occupational therapist (n = 3) Dietitian (n = 1) Social worker (n = 3) Physician (n = 8) Physiotherapist (n = 4) Registered nurse (n = 7) Assistant nurse (n = 6)

To study the perceptions of health care professionals on factors that may facilitate or hinder the quality of hospital-based geriatric care from an interdisciplinary team perspective.

Qualitative focus group interview Thematic framework approach

Interdisciplinary CGA led by a geriatrician. Assessment and care was proactive and goal-oriented with a focus on systematic preventive care processes. Specific team members were responsible for the care of each patient, which influenced the care procedures.

Geriatricianled team inclusive of registered nurses, nurse assistants, physiotherapists, occupational therapists, social workers with access to a dietician and speech therapist, as indicated.

Busetto et al. 2017 [37] Germany

Healthcare professionals working in a 150-bed geriatric hospital providing care to older adults aged ≥ 65 years with a range of diagnoses.

Total sample: n = 15 Medical doctor (n = 4) Occupational therapist (n = 4) Neuropsychologist (n = 3)

Physical therapist (n = 2) Registered nurse (n = 2)

(1)To describe the implementation of an integrated geriatric care intervention at a German geriatric hospital, and (2) to explore whether the application of an integrated geriatric care model provides insights into when and why beneficial outcomes can be achieved.

Qualitative semi-structured interviewcontext-mechanisms-outcomes (CMO) based model

Multidisciplinary CGA with a focus on standardised assessments and weekly team meetings. Assessment findings formed the basis of discussions at team meetings and further care planning.

Geriatrician-led team inclusive of occupational therapists, neuropsychologists, physical therapists, nurses, speech therapists and social workers.

Charalambous et al. 2016 [31] United Kingdom

Registered nurses working on acute medical healthcare of the older person wards in a large acute hospital trust in England.

Total sample: n = 8 Registered nurse (n = 8)

To understand how documentation may affect the quality of care in one acute hospital trust in England by understanding the experiences of registered nurses towards the documentation used while working in older person care in acute hospitals wards.

Qualitative semi-structured interview Thematic content analysis

The CGA process specific to the study site not reported.

Team composition not reported.

Darby et al. 2020 [30] United Kingdom

Older adults and their informal caregivers discharged directly home from an acute medical unit within 72 hours of attending hospital.

Total sample: n = 24 Older adult (n = 18) Caregiver (n = 6)

To gain an in-depth understanding of the older patient and informal carer experience of an acute medical unit stay and their experience of receiving the additional intervention from geriatricians.

Mixed methods Constructivist epistemology Semi-structured interview Thematic analysis

CGA delivered by a geriatrician who aimed to coordinate the delivery of additional immediate care or aftercare they deemed necessary. Such care could include a review of diagnoses; a drug review; further assessment at home or in a clinic or by recommending admission rather than discharge; advance care planning; or liaison with primary care, intermediate care, and specialist community services. The geriatricians liaised with hospital and community health professionals with the aim of enabling the CGA process to be delivered across the interface between the acute medical unit and the community.

Specialist geriatric medical assessment (either senior trainees or fully qualified specialists) in addition to the treatment routinely provided by the units’ consultant physicians and medical team. Patients were referred to a multidisciplinary team (physiotherapist, occupational therapist), as indicated.

de Vos et al. 2017 [33] Netherlands

Healthcare professionals working in 450-bed regional hospital with a 22-bed geriatric unit for older adults aged ≥ 70 years

Total sample: n = 10 Geriatric nurse (n = 2)

Transfer nurse (n = 2)

Team leader (n = 5) Internist (n = 1)

To identify factors impacting on the effectiveness of the implementation of a novel program, the Prevention and Reactivation Care Program (PReCaP), which targets hospital-related functional decline and geriatric care ‘as usual’ without use of an explicit program.

Mixed methods Semi-structured interview Thematic analysis

The PReCaP offers a bundle of goal-oriented interventions aimed at the physical, social and psychological domains of functional decline including identification of patient at risk within 48 h after admission, assessment of risk factors for functional decline, consultation with patient and relatives to discuss vulnerability and risk factors, biweekly multidisciplinary meeting and provision of support and treatment to informal caregiver.

Geriatrician, nursing home physician, nurses trained in geriatric care, nurse practitioners, social workers, transfer nurses, case managers, psychiatrists, psychologists, physiotherapists, occupational therapists, and dieticians, as indicated.

Gardner et al. 2019 [29] United Kingdom

(1) Older adults and their informal caregivers admitted to Older Person’s Acute Assessment Unit or a rehabilitation ward in a 48-bed community hospital, and (2) Healthcare professionals delivering CGA across varying service models (hospital inpatient and hospital-at-home).

Total sample: n = 31* Older adult (n = 12) Caregiver (n = 10) Healthcare professional (n = 9)

*sample pertains to inpatient hospital cohort only

To define and describe the structure, content and delivery of the CGA as practised in hospital and hospital-at-home based settings, from the perspective of healthcare professionals who deliver it and patients and caregivers who experience this type of health care.

Mixed methods Comparative case study Semi-structured interview Framework method

Older People’s Assessment Unit: the team identify patients from an accident and emergency department and a medical assessment unit to provide a timely, comprehensive assessment and plan of care for older patients, thereby contributing to decisionmaking about the appropriate ‘place of care’ at or near the beginning of the acute health event. The acute assessment is distributed across MDT members throughout the admission, with an average length of stay in the unit of 1.5 days. Community hospital: The team complete discipline-specific assessments within shared multidisciplinary ward notes. A standardised CGA document is not in use.

Older Person’s Acute Assessment Unit: Geriatrician-led team inclusive of registered nurses, (including a mental health nurse with experience of working with older people), physiotherapists, occupational therapists and Age UK staff. Community hospital: The rehabilitation ward was under the care of a consultant geriatrician with a frailty team based in the hospital. Composition of frailty team not reported.

Harvey et al. 2017 [36] Australia

(1) Older adults and their informal caregivers admitted to a 32-bed purpose-built Older Persons Evaluation, Rehabilitation and Assessment (OPERA) unit, and (2) Healthcare professionals working across hospital and primary care settings delivering care to older adults.

Total sample: n = 61 Older adult (n = 19) Caregiver (n = 19) Healthcare professional (n = 23)

(1) To identify ways to enhance the Geriatric Evaluation and Management (GEM) model of care, and (2) to describe the care transition experiences of older adults who transfer between subacute and primary care.

Exploratory, longitudinal case study design Semi-structured and focus group interview Thematic analysis

Delivered in a dedicated ward environment the multidisciplinary CGA focused on medical, psychosocial and rehabilitative care tailored to the older adult’s specific needs and promoted coordinated discharge planning.

Geriatrician-led team inclusive of registered nurses, nurse assistants, physiotherapists, occupational therapists and social workers.

Mäkelä et al. 2020 [28] United Kingdom

Older adults aged ≥ 65 years and their informal caregivers admitted to an acute care of the elderly ward or geriatrician-led care on a medical ward or community hospital.

Total sample: n = 36* Older adult (n = 19) Caregiver (n = 17)

*sample pertains to inpatient hospital cohort only

(1) To explore the work of patients and caregivers at the time of an acute health event, the interface with health professionals in hospital and hospital at home, and (2) how their experiences related to the principles that underpin CGA.

Mixed methods Semi-structured interview Normalisation process theory

The CGA process specific to the study sites not reported.

Team composition not reported.

Ribbink et al. 2021 [32] The Netherlands

Older adults aged ≥ 65 years and their informal care givers admitted to a 23-bed intermediate care facility in an acute geriatric community hospital.

Total sample: n = 18 Older adult (n = 13) Caregiver (n = 5)

To evaluate the patient experience and satisfaction with care at an acute geriatric community hospital.

Mixed methods Semi-structured interview Thematic analysis

The CGA was conducted on admission and provided an overview of all medical, functional, psychological and social problems. The CGA was discussed during multidisciplinary team meetings and used to formulate a care plan for each patient with a focus on early mobilisation and rehabilitation.

Geriatrician-led team inclusive of nurses trained in geriatric care, nurse assistants and physiotherapists.

Sifer-Rivière et al. 2011 [38] France

Healthcare professionals working in French Oncogeriatric Coordination Units providing care to cancer patients aged > 75 years

Total sample: n = 32* Geriatrician (n = 6) Surgeon (n = 5) Radiotherapist (n = 5) Oncologist (n = 5) Palliative care physician (n = 2)

Emergency physician (n = 2)

Anaesthetist (n = 2) Representatives from the French National Cancer Institute (n = 2)

*Three interviewees asked not to be recorded

To identify physicians views on the role of geriatric and oncologic tools in the organisation and management of medical oncogeriatric activities.

Qualitative Semi-structured interview Grounded theory analysis

The geriatric assessment focuses on evaluating the elderly patient’s general condition (vulnerability or very fragility) and to orient the search for signs of dependency or geriatric syndromes. The assessment procedures are perceived as complementary for medical decisionmaking based on other criteria such as autonomy, physiological reserves and cognitive capacity, etc. Variable levels of participation by geriatricians at multidisciplinary consulting meetings.

Team composition not reported.

Westgård et al. 2019 [34] Sweden

Older adults aged ≥ 75 years admitted to an acute geriatric medical ward.

Total sample: n = 10 Older adult (n = 10)

To explore how frail older adults experienced receiving CGA on an acute geriatric medical ward

Mixed methods Semi-structured interview Conventional content analysis

The CGA was person-centred and delivered by a multidisciplinary team to address the frail older adults’ multiple needs related to physical health, functional ability, psychological state, cognition, and social-environmental circumstances. Findings from the CGA were used to tailor individualised treatment and rehabilitation plans for the older adult.

The team consisted of medical doctors trained in geriatric medicine, nurses, nurse assistants, occupational therapists and physical therapists with access to a social worker and nutritionist, as indicated.