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 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 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.

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 MEASUREMENT OF GERIATRIC SURGERY OUTCOMES IN A NATIONAL REGISTRY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S401-S401
Author(s):  
Emily Finlayson
Keyword(s):  
Older Adult ◽  
Surgical Care ◽  
National Registry ◽  
Geriatric Surgery ◽  
Improvement Program ◽  
Medical Centers ◽  
National Quality ◽  
American College Of Surgeons ◽  
Surgery Outcomes

Abstract The American College of Surgeons National Quality Improvement Program started a “Geriatric Pilot” in January 2014. This project has already collected 19 additional older adult specialty variables in more than 60,000 patients undergoing operations. Twenty-six medical centers participate from across North America. The variables collect information in the domains of cognition, function, mobility and decision-making. Variables are collected in both the pre- and post-operative settings. It is clear that the quality of surgical care cannot be limited to the immediate hospitalization. The pilot has recently expanded its use of longer-term outcomes and has begun collecting 30-day outcomes of functional status and living location.

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 EFFECTIVENESS VS. EFFICACY: CREATING EVIDENCE FROM GERIATRIC SURGERY QUALITY PROGRAMS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S401-S401
Author(s):  
Meixi Ma
Keyword(s):  
Older Adults ◽  
Postoperative Delirium ◽  
Geriatric Surgery ◽  
Improvement Program ◽  
Surgical Quality ◽  
Quality Program ◽  
National Quality ◽  
American College Of Surgeons ◽  
Quality Programs ◽  
Trajectory Following

Abstract The American College of Surgeons National Quality Improvement Program started a “Geriatric Pilot” in January 2014. This initiative has collecting specialty variable related to older adults in more than 60,000 patients 65 years and older undergoing operations. Multiple research publications have been generated from this pioneering national quality program focused on surgical quality in older adults. The purpose of this presentation will be to review the major findings of this new body of research. Studies have focused on functional trajectory following operations, postoperative delirium, and peri-operative decision-making.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

Mobile Applications for Health Management of Older Adults: A Scoping Review (Preprint)

2020 ◽  
Author(s):  
Nurul Asilah Ahmad ◽  
Shahrul Azman Mohd Noah ◽  
Arimi Fitri Mat Ludin ◽  
Suzana Shahar ◽  
Noorlaili Mohd Tohit
Keyword(s):  
Older Adults ◽  
Goal Setting ◽  
Mobile Applications ◽  
Health Management ◽  
Mobile Apps ◽  
Personalized Feedback ◽  
Self Monitoring ◽  
App Store ◽  
Evidenced Based ◽  
Google Play

BACKGROUND Currently, the use of smartphones to deliver health-related content has experienced a rapid growth, with more than 165,000 mobile health (mHealth) applications currently available in the digital marketplace such as iOS store and Google Play. Among these, there are several mobile applications (mobile apps) that offer tools for disease prevention and management among older generations. These mobile apps could potentially promote health behaviors which will reduce or delay the onset of disease. However, no review to date that has focused on the app marketplace specific for older adults and little is known regarding its evidence-based quality towards the health of older adults. OBJECTIVE The aim of this review was to characterize and critically appraise the content and functionality of mobile apps that focuses on health management and/or healthy lifestyle among older adults. METHODS An electronic search was conducted between May 2019 to December 2019 of the official app store for two major smartphone operating systems: iPhone operating system (iTunes App Store) and Android (Google Play Store). Stores were searched separately using predetermined search terms. Two authors screened apps based on information provided in the app description. Metadata from all included apps were abstracted into a standard assessment criteria form. Evidenced based strategies and health care expert involvement of included apps was assessed. Evidenced based strategies included: self-monitoring, goal setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, cognitive training and social support. Two authors verified the data with reference to the apps and downloaded app themselves. RESULTS A total of 16 apps met the inclusion criteria. Six out of 16 (37.5%) apps were designed exclusively for the iOS platform while ten out of 16 (62.5%) were designed for Android platform exclusively. Physical activity component was the most common feature offered in all the apps (9/16, 56.3%) and followed by cognitive training (8/16, 50.0%). Diet/nutrition (0/16, 0%) feature, however, was not offered on all reviewed mobile apps. Of reviewed apps, 56.3% (9/16) provide education, 37.5% (6/16) provide self-monitoring features, 18.8% (3/16) provide goal setting features, 18.5% (3/16) provide personalized feedback, 6.3% (1/16) provide social support and none of the reviewed apps offers heart rate monitoring and reminder features to the users. CONCLUSIONS All reviewed mobile apps for older adults in managing health did not focused on diet/nutrition component, lack of functional components and lack of health care professional involvement in their development process. There is also a need to carry out scientific testing prior to the development of the app to ensure cost effective and its health benefits to older adults. Collaborative efforts between developers, researchers, health professionals and patients are needed in developing evidence-based, high quality mobile apps in managing health prior they are made available in the app store.

scholarly journals Lessons from failure: neurosurgical outreach in Managua, Nicaragua

2021 ◽  
Vol 37 (10) ◽  
pp. 3083-3087
Author(s):  
Rahul Jandial ◽  
Pranay Narang ◽  
Jorge Daniel Brun Aramayo ◽  
Michael Levy
Keyword(s):  
Medical Center ◽  
Video Conferencing ◽  
Surgical Care ◽  
Effective Communication ◽  
Developing Nations ◽  
Developing Regions ◽  
Digital Collaboration ◽  
State Of Affairs

AbstractWith respect to the tremendous deficit in surgical care plaguing developing nations, it is critical that medical outreach models be organized in such a fashion that sustainable advancements can be durably imparted beyond the duration of targeted missions. Using a didactic framework focused on empowering host neurosurgeons with an enhanced surgical skillset, a mission was launched in Managua, Nicaragua, after previous success in Kiev, Ukraine, and Lima, Peru. Unfortunately, the failure to critically assess the internal and external state of affairs of the region’s medical center compromised the outreach mission. Herein lies the visiting team’s lessons from failure and insights on facilitating effective communication with host institutions, circumventing geopolitical instability, and utilizing digital collaboration and video-conferencing tools in the post-COVID-19 era to advance the surgical care of developing regions in a fashion that can be generationally felt.

scholarly journals Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 686-686
Author(s):  
Erin Emery-Tiburcio ◽  
Rani Snyder
Keyword(s):  
Older Adults ◽  
New York ◽  
Health System ◽  
Medical Center ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
New York University ◽  
The Us ◽  
Treatment Plans

Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.

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