FUTURE DIRECTIONS: DISSEMINATION OF STANDARDIZED GERIATRIC SURGERY CARE NATIONALLY

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.

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LAUNCHING STANDARDIZED GERIATRIC SURGERY PROGRAMS: THE ALPHA AND BETA PILOTS

Innovation in Aging ◽

10.1093/geroni/igz038.1488 ◽

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.

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MEASUREMENT OF GERIATRIC SURGERY OUTCOMES IN A NATIONAL REGISTRY

Innovation in Aging ◽

10.1093/geroni/igz038.1486 ◽

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.

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CREATION OF EVIDENCE-BASED GERIATRIC SURGERY STANDARDS

Innovation in Aging ◽

10.1093/geroni/igz038.1485 ◽

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.

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

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2016.06.246 ◽

2016 ◽

Vol 223 (4) ◽

pp. S119 ◽

Cited By ~ 1

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

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Can proportion of children achieving HbA1c below 58 mmol/mol within the first year of diagnosis be used as a standard of quality of care provided for children with type 1 diabetes?

Endocrine Abstracts ◽

10.1530/endoabs.36.p26 ◽

2014 ◽

Author(s):

Clare Harrison ◽

Ingrid Wilkinson ◽

Binu Anand ◽

Rachel Furley ◽

Nadeem Abdullah ◽

...

Keyword(s):

Type 1 Diabetes ◽

Quality Of Care ◽

First Year

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Ready for prime time: role for geriatric assessment to improve quality of care in hematology practice

Hematology ◽

10.1182/hematology.2019001299 ◽

2019 ◽

Vol 2019 (1) ◽

pp. 53-58 ◽

Cited By ~ 1

Author(s):

Heidi D. Klepin

Keyword(s):

Older Adults ◽

Quality Of Care ◽

Geriatric Assessment ◽

Hematologic Malignancies ◽

Patient Centered ◽

Functional Reserve ◽

Centered Care ◽

Assessment Measures

Abstract Older adults represent the growing majority of patients diagnosed with hematologic disorders, yet they remain underrepresented on clinical trials. Older patients of the same chronologic age differ from one another with varying comorbidity and functional reserve. The concepts of frailty and resilience are important to patient-centered care and are patient and setting specific. The use of geriatric assessment to inform tailored decision making and management can personalize care for older adults with hematologic malignancies. This article will highlight available evidence to support the role of geriatric assessment measures to enhance quality of care for older adults diagnosed with hematologic malignancies.

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