In an Australian-first, the Royal Melbourne Hospital (RMH) has launched a new service to support older trauma patients.

Trauma in Older Persons Service (TOPS) team
Dr Rachel Aitken (right) and the RMH TOPS team.

It’s a phrase you might not have heard before, but geriatrician, Dr Rachel Aitken says it’s exactly what the new Trauma in Older Persons Service – or TOPS – is targeting.

The team of geriatricians, with an advanced trainee and resident, see people over 65 admitted under the trauma team. That means lots of high and low falls, but also 70-year-olds with motorbike accidents too.

“We’ve been collecting data to improve the journey for this group of patients and reduce their length of stay, but more importantly, their quality of care,” Dr Aitken explains.

Geriatricians have always worked closely with trauma teams, but this is the first time they’ve had their own service.

By bringing in TOPS early – sometimes within 48 hours of arrival – and closely collaborating with the trauma and allied health, the team can facilitate patient needs, particularly when medical care begins to outweigh trauma care in the hospital journey.

“We’re particularly focused on people with fragility, cognitive and functional impairment who have high care needs,” said Dr Aitken.

“We may not be able to prevent life changes like moving to nursing homes, but it’s about having those conversations and person-centred care approach,” she added.

Mobile Stroke Unit with Ambulance Victoria paramedic and the RMH Stroke team
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