The decision to have a surgical procedure when a patient is elderly can be a daunting one for caregivers, adult children, and the patients themselves. The reality is that older adults have different physiology and unique set of needs that may make them more vulnerable to complications following a procedure. Thus, the question becomes, “will this operation make them better or worse?”
These questions will only increase because of the aging population. Older adults already account for about 41 percent of all in-patient operations performed each year in the U.S.[1], and this number will continue to increase with 10,000 people turning 65 each day.
Fortunately, the American College of Surgeons (ACS) embarked on a project four years ago to develop new standards to improve surgical care for older patients.
The new Geriatric Surgery Verification (GSV) Program was announced this summer and introduced 30 new surgical standards designed to systematically improve surgical care and outcomes for the aging adult population. ACS, with support from The John A. Hartford Foundation, led a group of 50 stakeholder organizations, in the development of the program.
One of the most critical standards addresses how doctors communicate with patients to make sure that the patient’s goals align with their care. For instance, a patient who wants to live as long as possible may decide to opt for a major cancer surgery despite the risks. Another patient may focus on the quality of life over quantity of time and choose to forego the operation.
Another addresses how clinicians screen patients before surgery to assess for things such as cognitive issues, potential delirium and strength, and balance. After the operation, doctors want to make sure their patient is lucid, can avoid falls and be able to get out of bed and walk. Discovering these issues before surgery helps to identify potential problems that may occur during recovery.
Some of the other standards include:
- Better management of medications
- Providing geriatric-friendly rooms
- Ensuring proper staffing is in place
- Return of Personal Sensory Equipment (glasses, hearing aids, dentures, etc.)
- Communication with Post-Acute Care Facilities
ACS believes this program is relevant to all hospitals that take care of elderly patients undergoing surgery. If hospitals choose to become a verified geriatric center, they will need to be surveyed by ACS to verify they meet all the standards. The same as how ACS verifies Trauma Centers in the U.S.
The enrollment process for hospitals will begin in late October 2019.
[1] Centers for Disease Control. National Hospital Discharge Survey: Number of All-Listed Procedures for Discharges from Short-Stay Hospitals, by Procedure and Age: United States, 2010.