Coalition for Quality in Geriatric Surgery: Intermediate Report on Establishing Consensus for High Quality Surgical Care for Older Adults

2016 ◽  
Vol 223 (4) ◽  
pp. S119 ◽  
Author(s):  
Julia R. Berian ◽  
Ronnie A. Rosenthal ◽  
Tracey L. Baker ◽  
Clifford Y. Ko ◽  
Marcia M. Russell
Keyword(s):  
Older Adults ◽  
Surgical Care ◽  
Geriatric Surgery ◽  
High Quality

scholarly journals FUTURE DIRECTIONS: DISSEMINATION OF STANDARDIZED GERIATRIC SURGERY CARE NATIONALLY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S401-S401
Author(s):  
Mark Katlic
Keyword(s):  
Older Adults ◽  
Quality Of Care ◽  
Surgical Care ◽  
First Year ◽  
Geriatric Surgery ◽  
High Quality ◽  
Future Directions ◽  
Medical Centers ◽  
National Initiative

Abstract The American College of Surgeon’s Coalition for Quality in Geriatric Surgery will formally launch a national initiative aimed to improve the quality of surgical care for all older adults in July 2019. The first-year goal will be to recruit and successfully verify 100+ medical centers. This presentation will provide an overview of dissemination efforts for the standards set for providing high quality surgical care for older adults as well as processes to measure the quality of care provided to older adults at these medical centers. It our vision that this national initiative will lead the effort to the improvement of surgical care of all older adults.

scholarly journals LAUNCHING STANDARDIZED GERIATRIC SURGERY PROGRAMS: THE ALPHA AND BETA PILOTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S401-S401
Author(s):  
Lindsey Zhang
Keyword(s):  
Older Adults ◽  
Medical Center ◽  
Surgical Care ◽  
Alpha Phase ◽  
Geriatric Surgery ◽  
High Quality ◽  
Patient Goals ◽  
National Quality ◽  
Care Models ◽  
Evidenced Based

Abstract Then Coalition for Quality in Geriatric Surgery has completed both alpha and beta pilots which represent the initial efforts to launch this national quality initiative to improve the care of all older adults undergoing operations. The alpha phase included hospital stakeholders rating the feasibility of implementing standards related to evidence-based high quality surgical care for older adults on the topics of eliciting patient goals, completing a preoperative frailty risk assessment, educating healthcare professional about care specific to older adults, and implementing postoperative age-friendly care models. The beta pilot phase required 9 medical centers nationally (including an academic hospital, an urban medical center, a Kaiser hospital, a VA hospital and a rural hospital) to implement the evidenced based standards for high quality surgical care of older adults. Site verification visits were completed in the Summer 2018 which evaluated the effectiveness of each medical center’s ability to implement each of the standards.

scholarly journals CREATION OF EVIDENCE-BASED GERIATRIC SURGERY STANDARDS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S400-S401
Author(s):  
Marcia McGory Russell
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Adult Population ◽  
Acute Care Hospital ◽  
Surgical Care ◽  
Transitions Of Care ◽  
Standards Of Care ◽  
Care Hospital ◽  
Geriatric Surgery ◽  
High Quality

Abstract The aim of this abstract is to describe how to establish high-quality, valid standards to improve surgical care of the older adult. The older adult population has high demand for high-quality surgical care. Building upon prior guidelines, quality indicators, and pilot projects, the Coalition for Quality in Geriatric Surgery (CQGS) included 58 diverse stakeholder organizations committed to improving surgery for older adults. Using a modified RAND-UCLA Appropriateness Methodology, 44 of 58 CQGS Stakeholders twice rated validity (primary outcome) and feasibility for 308 standards, ranging from goals and decision-making, pre-operative assessment and optimization, perioperative and postoperative care, to transitions of care beyond the acute care hospital. Stakeholders rated the vast majority of standards of care as highly valid (99%) and feasible (94%) for improving the quality of surgical care provided to older adults.

scholarly journals PRESIDENTIAL SYMPOSIUM: OPTIMIZING SURGICAL CARE FOR ALL OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S400-S400
Author(s):  
Thomas Robinson ◽  
Ronnie Rosenthal
Keyword(s):  
Older Adults ◽  
Quality Improvement ◽  
Surgical Care ◽  
Social Needs ◽  
Geriatric Surgery ◽  
Patient Centered ◽  
Improvement Program ◽  
Continuous Quality ◽  
Operative Care ◽  
The Individual

Abstract Our program will provide a detailed overview with an emphasis on the research aspects of the new Coalition for Quality in Geriatric Surgery, a project supported by the American College of Surgeons and the John A. Hartford Foundation. This project is a national endeavor which aims to systematically improve the surgical care of older adults by establishing a verifiable quality improvement program with standards based on best evidence focused on what matters most to the individual patient. We believe there is a critical need for safe, high-quality, patient-centered surgical care for older adults. Aging surgical patients have unique physiological needs, social needs and unique goals of care. We formed the Coalition to help hospitals meet these rising needs by setting and verifying interdisciplinary standards and developing outcome measures that matter to older patients, families and caregivers. In collaboration with our 50+ stakeholder organizations, we have set the standards, developed measures that matter, educated providers and patients, and created awareness about the surgical needs of older adults at all hospitals through the program. The geriatric surgery program, set to launch in the Summer of 2019, will use the four principles of continuous quality improvement: set standards, define the right infrastructure, collect rigorous data, and verify. The program not only improves perioperative care, but also impacts the full cycle of care for older adults. Our group has harnessed the power of networks through partnership and collaboration of all disciplines involved in the peri-operative care of older adults.

scholarly journals 90 Falls Efficacy Related Instruments for Community-Dwellig Older Adults – Development and Content Validity: A Cosmin-Based Systematic Review

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27 ◽  
Author(s):  
Shawn Leng-Hsien Soh ◽  
Chee-Wee Tan ◽  
Lane Judith ◽  
Nigel Gleeson ◽  
Tim Xu
Keyword(s):  
Older Adults ◽  
Content Validity ◽  
Community Dwelling ◽  
High Quality ◽  
Structural Validity ◽  
Balance Confidence ◽  
High Quality Evidence ◽  
Community Dwelling Older Adults ◽  
Quality Evidence ◽  
Selection Of

Abstract Background Falls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. Empirical evidence is needed to justify the selection of a specific instrument to measure the intended construct. Objectives To summarize evidence on the development, content validity and structural validity of instruments measuring falls efficacy in community-dwelling older adults using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Study Design and Setting MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology guided the review of eligible studies and methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesized. A modified GRADE approach was applied to evidence synthesis. Results 35 studies on 18 instruments were included in the review. High quality evidence showed that modified Falls-Efficacy Scale (FES)–13 items (mFES-13) is relevant but not comprehensive for measuring falls efficacy. Moderate quality evidence supported the FES-10 had sufficient relevance and the mFES-14 had sufficient comprehensibility. Only the Activities-specific Balance Confidence (ABC) Scale–Simplified (ABC-15) had sufficient relevance of moderate quality evidence to measure balance confidence. Low to very low quality evidence underpinned content validity of other instruments. High quality evidence supported sufficient unidimensionality for eight instruments (FES-10, mFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES–International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)). Conclusion Content validity of the instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate the broader continuum of falls efficacy.

scholarly journals What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review

2019 ◽  
Vol 54 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Ivan Lin ◽  
Louise Wiles ◽  
Rob Waller ◽  
Roger Goucke ◽  
Yusuf Nagree ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
Quality Care ◽  
Surgical Care ◽  
High Quality ◽  
Eligibility Criteria ◽  
Evidence Database

ObjectivesTo identify common recommendations for high-quality care for the most common musculoskeletal (MSK) pain sites encountered by clinicians in emergency and primary care (spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis [OA] and shoulder) from contemporary, high-quality clinical practice guidelines (CPGs).DesignSystematic review, critical appraisal and narrative synthesis of MSK pain CPG recommendations.Eligibility criteriaIncluded MSK pain CPGs were written in English, rated as high quality, published from 2011, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.Data sourcesFour scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories.Results6232 records were identified, 44 CPGs were appraised and 11 were rated as high quality (low back pain: 4, OA: 4, neck: 2 and shoulder: 1). We identified 11 recommendations for MSK pain care: ensure care is patient centred, screen for red flag conditions, assess psychosocial factors, use imaging selectively, undertake a physical examination, monitor patient progress, provide education/information, address physical activity/exercise, use manual therapy only as an adjunct to other treatments, offer high-quality non-surgical care prior to surgery and try to keep patients at work.ConclusionThese 11 recommendations guide healthcare consumers, clinicians, researchers and policy makers to manage MSK pain. This should improve the quality of care of MSK pain.

Racial Disparities In Access To High Quality Hospitals For Surgical Care

2011 ◽  
Vol 165 (2) ◽  
pp. 199
Author(s):  
G. Rangrass ◽  
J.D. Birkmeyer ◽  
J.B. Dimick
Keyword(s):  
Racial Disparities ◽  
Surgical Care ◽  
High Quality

scholarly journals Safety of elective abdominal and vascular surgery during the COVID-19 pandemic: a retrospective single-center study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Sven Flemming ◽  
Mohammed K. Hankir ◽  
Simon Kusan ◽  
Manuel Krone ◽  
Friedrich Anger ◽  
...  
Keyword(s):  
Screening Program ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Hospital ◽  
High Quality ◽  
Surgical Department ◽  
Number Of Patients ◽  
Single Center Study ◽  
Study Population ◽  
Lower Franconia

Abstract Background Patients with coronavirus disease 2019 (COVID-19) who undergo surgery have impaired postoperative outcomes and increased mortality. Consequently, elective and semi-urgent operations on the increasing number of patients severely affected by COVID-19 have been indefinitely postponed.in many countries with unclear implications on disease progression and overall survival. The purpose of this study was to evaluate whether the establishment of a standardized screening program for acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sufficient to ensure high-quality medical and surgical treatment of COVID-19 and non-COVID-19 patients while minimizing in-hospital SARS-CoV-2 transmission. Methods The screening program comprised polymerase chain reaction (PCR) testing of nasopharyngeal swabs and a standardized questionnaire about potential symptoms for SARS-CoV-2 infection. All elective and emergency patients admitted to the surgical department of a tertiary-care hospital center in Lower Franconia, Germany, between March and May 2020 were included and their characteristics were recorded. Results Out of the study population (n = 657), 509 patients (77.5%) had at least one risk factor for a potentially severe course of COVID-19 and 164 patients (25%) were active smokers. The average 7-day incidence in Lower Franconia was 24.0/100,000 during the observation period. Preoperative PCR testing revealed four asymptomatic positive patients out of the 657 tested patients. No postoperative SARS-CoV-2 infection or transmission could be detected. Conclusion The implementation of a standardized preoperative screening program to both COVID-19 and non-COVID-19 patients can ensure high-quality surgical care while minimizing infection risk for healthcare workers and potential in-hospital transmission.

scholarly journals Protocolo ERAS® en cirugía colorrectal

2021 ◽  
Vol 113 (2) ◽  
pp. 176-188
Author(s):  
William Maclean ◽  
◽  
Paul Mackenzie ◽  
Chris Limb ◽  
Timothy Rockall
Keyword(s):  
Colorectal Surgery ◽  
Stress Reduction ◽  
Multidisciplinary Approach ◽  
Physiological Stress ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Surgical Care ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Research

Enhanced Recovery After Surgery (ERAS®) in colorectal surgery is a protocol that promotes quicker return to function. It follows the latest evidence-based research to promote stress reduction related to surgery. The recommended perioperative pathway is fine-tuned, dynamic and in line with the latest evidence-based research to enhance all aspects of the patient’s surgical care. We describe the four aspects for a patient undergoing colorectal surgery – pre-admission, pre-operative, intra-operative and post-operative. The running theme is to reduce overall physiological stress related to surgery and interventions overlap throughout the patient’s pathway. Using a multidisciplinary approach, adherence to ERAS® in colorectal surgery with ≥70 % compliance to the ERAS interventions has shown a risk reduction of 5-year cancer-related death by 42%. The optimum interventions are not only determined through the publication of high-quality research, but regular international collaboration enables experience and research to be shared and care standardised

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