Table 2.

Barriers and Countermeasures Suggested by the Authors

Barrier	Suggested countermeasure
Physician leadership	Selection of consensus building leaders3
Need for case manager	Selection of experienced nurse or mid-level provider from the hospital is a good option
Anesthesia department support	Need for team building and use of standard accepted guidelines for preoperative consultation19
Operating room time availability	Needs for block time for geriatric fracture cases to permit early surgery20
Administrative support	Best managed with education about the benefits of a program1-4
Difficulty with cardiac clearance	Adherence to national guidelines21 and use of standard medical consultation forms
Lack of data	Direct discussions with hospital quality management and finance departments to establish data available and plan for future collection. Administrative support required4