Geriatric Surgery Verification (GSV) Program

Indications

• older adults >=75 years of age undergoing inpatient surgery
• goals: maximize benefit to patients & minimize burden of surgery

Procedure

• Components:
  • Institutional Commitment
  • Geriatric Surgery Director
  • Geriatric Surgery Coordinator
  • Geriatric Surgery Quality Committee
  • Geriatric-Friendly Patient Rooms
  • Geriatric Surgery Nurse Champion
• Goals & Decision Making
  • Treatment & Overall Health Goals
  • Code Status & Advance Directives
  • Medical Proxy
  • Life-Sustaining Treatment Discussion for Patients with Planned ICU Admission
  • Reaffirm Surgical Decision Making
• Preoperative Work-Up
  • Geriatric Vulnerability Screens
  • Management Plan for Patients with Positive Geriatric Vulnerability Screens
  • Surgeon-PCP Communication for Elective, High-Risk Patients
• Postoperative Management
  • Return of Personal Sensory Equipment
  • Inpatient Medication Management
  • Opioid-Sparing, Multimodality Pain Management
  • Standardized Postoperative Care
  • Interdisciplinary Care for High-Risk Patients
  • Revisiting Goals of Care for ICU Patients
  • Assessment of Geriatric Vulnerabilities at Discharge
• Transitions of Care
  • Discharge Documentation & Hand-Off Communication
  • Communication with Post-Acute Care Facilities
• Data Surveillance & Systems
  • Data Collection & Review
  • Data Feedback to Frontline Providers & Quality Infrastructure
• Quality Improvement
  • Geriatric Surgery Quality Improvement/Process Improvement Project
  • [Optional] Geriatric Surgery ACS NSQIP Collaborative
• Professional & Community Outreach
  • Geriatric Surgery Community Outreach Project
  • Geriatric Education of Surgeons & Advanced Practice Providers
  • Geriatric Education of Nurses
• Research
  • [Optional] Advancement of Knowledge in Geriatric Surgical Care

Notes

• discussion of cost-effectiveness of GSV program

More general terms

• quality indicator (QI); quality measure