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American College of Surgeons releases standards for surgical care of older adults


July 19, 2019

By Megan Brooks

NEW YORK (Reuters Health) - The American College of Surgeons (ACS) has introduced a new surgical quality improvement program for hospitals that aims to promote high-quality surgical care for older adults.

The ACS launched the Geriatric Surgery Verification (GSV) Program today at the ACS Quality and Safety Conference in Washington, D.C.

"The population is aging and the number of surgical patients who are older and have vulnerabilities has been increasing very rapidly. Currently, about 40% of the surgical procedures we do are on patients over the age of 65," Dr. Ronnie A. Rosenthal, Chair of the ACS Geriatric Surgery Taskforce and professor of surgery and geriatrics at Yale University School of Medicine in New Haven, Connecticut, noted in a phone interview with Reuters Health.

Older adults have unique needs and goals for their care that warrant a more thorough and individualized approach to surgery, Dr. Rosenthal explained.

The GSV Program provides hospitals with 30 evidence-based and patient-centered standards for geriatric surgery that hospitals can implement to continuously optimize surgical care for older patients.

These standards define the resources and processes that hospitals need to have in place to perform surgeries effectively, efficiently, and safely in their older patients, while also prioritizing what matters most to individual patients with regard to their needs and treatment goals. The standards include recommendations for improving communications between patients and the health care team, managing medications, screening for cognitive, nutrition, and mobility decline, and ensuring proper staffing is in place.

"We know that the elderly are at higher risk for various issues when undergoing surgery. This is a program dedicated to taking better care of older surgical patients," Dr. Clifford Y. Ko, Director of the ACS Division of Research and Optimal Patient Care and professor of surgery at the University of California-Los Angeles David Geffen School of Medicine, told Reuters Health by phone.

"Aligning patient goals with treatment is one of the standards that we think is paramount, and it's what our stakeholders told us over and over again. That might mean not having an operation, it might mean having a large operation, it might mean having a small operation. The decision is led by the patient sharing his or her own goals for the operation," said Dr. Ko.

The ACS, with support from The John A. Hartford Foundation, led a group of over 50 stakeholder organizations in developing the GSV Program and its surgical standards. The program is designed to be applicable to all U.S. hospitals, regardless of size, location, or teaching status. The standards were "rigorously piloted and refined to ensure they are meaningful, without being so burdensome that hospitals would find it difficult to implement them," the ACS notes in a news release.

Hospitals will be able to apply and formally enroll in the GSV program beginning in October 2019 at the ACS Clinical Congress in San Francisco. Hospitals interested in learning more about the application and enrollment process can contact the American College of Surgeons at geriatricsurgery@facs.org, or visit www.facs.org/geriatrics.

In the news release, ACS Executive Director Dr. David B. Hoyt says, "Our quality program for geriatric surgery is built on the past success of other ACS quality programs in cancer, trauma, bariatric, and pediatric surgery. It's based on a proven foundation and shows great potential to transform the way surgical care is approached for older adults across the nation. Moreover, the program is being released at an auspicious time. More people are growing older and seeking surgical care, while at the same time our health care system is showing a probable shift toward creating a safer and more efficient care system that's patient-centered."

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