American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

National Program to Improve the Quality of Geriatric Surgical Patient Care Announced by American College of Surgeons and John A. Hartford Foundation


John A. Hartford FoundationCHICAGO (June 11, 2015): Today, the American College of Surgeons (ACS), in partnership with the John A. Hartford Foundation (JAHF), announced it will conduct a four-year initiative that will lead to improved care of older surgical patients through a standards and verification program for hospitals.  The respective leaders for this initiative are pioneers in the field of geriatric surgery and long-time Hartford grantees, Clifford Y. Ko, MD, FACS, Director of the ACS Division of Research and Optimal Patient Care, and Ronnie Rosenthal, MD, FACS, Chair of the ACS Geriatric Surgery Task Force and chief of surgery at the VA Connecticut Healthcare System.  The grant amount awarded by JAHF for the program is $2.9 million.

ACS logoOne of the driving forces behind this essential initiative is America’s expanding geriatric population.  The U.S. Census Bureau reports that more people were 65 years and older in 2010 than in any previous census.  Moreover, the largest percentage point increase for the “oldest-old population” (defined as starting at age 85) over the previous two decades was concentrated in the 90 to 94 year old age group, which increased from 25.0 percent of the oldest-old group in 1990 to 26.2 percent in 2000, and 26.4 percent in 2010.1

"More than ever, 80, 90, and even 100-year-olds are undergoing surgery and that trend will only grow.  This important partnership between the John A. Hartford Foundation and the American College of Surgeons to develop standards and then verify that hospitals can deliver optimal geriatric surgical care will save lives, improve outcomes, and reduce harm for older adults across the country," said Terry Fulmer, PhD, RN, FAAN, President, the John A. Hartford Foundation.

Quality geriatric surgical care is an area of prime consideration to the ACS.  In 2012, ACS published joint guidelines in partnership with the American Geriatrics Society in the Journal of the American College of Surgeons for the perioperative care of the nation’s elderly patients.2  These guidelines apply to every surgical patient 65 years and older as defined by Medicare regulations.

“We have worked with the John A. Hartford Foundation for many years to develop meaningful tools for improving geriatric surgical care. The current project aims to develop and integrate geriatric surgery standards that will help facilities with infrastructure, standards, processes and protocols, and the integration of data—all to improve the care of the geriatric surgical patient,” said Dr. Ko.

The Geriatric Surgery Verification and Quality Improvement Program will produce a framework generalizable to all hospitals—regardless of size, location, or population served—to improve the quality of care they provide to older adults undergoing surgery.  The project will convene experts and engage a broad set of stakeholders representing patients, families, caregivers, multidisciplinary health providers, industry, payers, and others, with the following objectives:

  • Set standards for hospitals related to the needed infrastructure for optimal care (staffing, resources, care processes, etc.)
  • Select and develop measures that matter for older patients against which hospitals can be assessed and target improvement (this objective will include new patient-reported outcomes)
  • Develop patient and provider educational resources
  • Build a peer-review verification program that promotes public assurance and a culture of improvement, similar to the ACS’s successful cancer, trauma, and bariatric quality programs, which have shown to improve care and save lives

“There is great opportunity to improve the care and outcomes of geriatric surgery patients – and is relevant to nearly all fields in surgery. This program will involve several disciplines and be a total team effort,” said Dr. Ko.

This work builds on the ACS’s robust data collection and quality improvement infrastructure. It will draw upon the network of experts and growing evidence base in geriatric surgery that has been developed with JAHF support over the past 20 years.

“The ACS has a long and successful track record of helping hospitals build an infrastructure for surgical quality improvement,” said Christopher A. Langston, PhD, Program Director at the John A. Hartford Foundation. “This new verification program will make it easier for hospitals and health systems to focus on doing their best for the large and vulnerable patient population of older adults – and receive public credit for providing them with the right kind of care.”

1 U.S. Census Bureau Statistical Brief. The Older Population: 2010. Available at  Accessed June 9, 2015.
2 Chow WB, Rosenthal RA, Merkow RP, et al. Optimal Preoperative Assessment of the Geriatric Surgical Patient: A Best Practices Guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg. 2012;215(4):453-466.

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 80,000 members and is the largest organization of surgeons in the world. For more information, visit

About The John A. Hartford Foundation
The John A. Hartford Foundation is a private philanthropy working to improve the health of older Americans.  After three decades of championing research and education in geriatric medicine, nursing, and social work, today the Foundation pursues opportunities to put geriatrics expertise to work in all health care settings. This includes advancing practice change and innovation, supporting team-based care through interdisciplinary education of all health care providers, supporting policies and regulations that promote better care, and developing and disseminating new evidence-based models that deliver better, more cost-effective health care. The Foundation was established by John A. Hartford.  Mr. Hartford and his brother, George L. Hartford, both former chief executives of the Great Atlantic & Pacific Tea Company, left the bulk of their estates to the Foundation upon their deaths in the 1950s.  For more information, visit


Dan Hamilton

Marcus Escobedo (John A. Hartford Foundation)