The American College of Surgeons (ACS) was awarded a four-year grant from the John A. Hartford Foundation (JAHF) to develop and implement a Geriatric Surgery Verification and Quality Improvement Program (referred to here as “the Program”). This broad-reaching quality program will be designed to systematically improve care and outcomes for the older adult surgical patient. The grant period began on July 1, 2015 and a set of stakeholders (the Coalition for Quality in Geriatric Surgery) has been convened during the initial stages of developing the program.
A team of ACS members with geriatric expertise and ACS staff will work with a diverse group of stakeholders to:
Engage Key Stakeholders
Multidisciplinary engagement will play a key role in program development. Stakeholders representing several health professions, patients and families, and payors will vet the standards and contribute to the development of patient-centered outcome measures. Three stakeholder meetings will be conducted during the course of the grant. A select group of stakeholder partners will serve as the advisory panel for the Program. This group will provide guidance throughout the four years of the Program and will meet annually.
Set the Standards
The core development team, advisory panel, and multidisciplinary stakeholder groups will convene to set the standards for geriatric surgical care. These standards will define the processes, resources, and infrastructures necessary for the optimal care of the older adult surgical patient. They will be based on scientific evidence when possible and expert consensus where no evidence exists.
Develop Measures That Matter
Data collection will include existing and new 30-day process and outcome measures that are patient-centered. The measures should closely reflect issues of importance to both the older adult patient undergoing surgery and the patient’s caregivers. Stretch Goal: Collection of patient-reported, late outcomes will be explored. These measures are known to be more challenging to collect. Feasibility of identifying and collecting these data will be evaluated. The Program will move forward with the primary measures regardless of our ability to implement the stretch goal.
Develop the Verification Process to Ensure Delivery of High-Quality Care
Use of the standards must be verified in order to build public trust and ensure success of the program. Building on ACS’ past experiences, we will add to our infrastructure in order to consistently and reliably perform verification.
Pilot the Program
A pilot program will be conducted to test the feasibility of the standards, data measures, and verification process. The Program will be refined with information from the pilot.
Educate Patients and Providers
Educational materials will be developed for patients, families, and caregivers about key elements of geriatric surgical care. Educational programs and innovative tools will be developed for providers to enhance their understanding of geriatric issues related to surgical care. These materials and tools will be widely disseminated and easily accessed in order to promote consistent, high-quality surgical care of the older adult.
Launch the Geriatric Surgery Quality Campaign
We will promote the Program widely through a quality campaign, including communication and marketing tools and site enrollment. The launch of the Program will be initiated with a multidisciplinary Geriatric Surgery Quality Summit, designed to bring national awareness to the need for quality care of the older surgical patient.
The Geriatric Surgery Verification and Quality Improvement Program will provide a framework for the optimal care of the geriatric surgical patient, generalizable to more than 4,000 facilities regardless of size, location, or teaching status. Once established, the Program will reside with other verification programs in the Division of Research and Optimum Patient Care, where it will be maintained by ACS staff. The ACS has been committed to geriatric surgery for many years. The ACS and JAHF have collaborated on numerous initiatives over the last 20 years, a history and connection that make these two organizations ideal partners in pursuing this program. The partnership between ACS and JAHF will create the momentum and provide the resources necessary to develop this essential product which will systematically improve the quality of geriatric surgery across the United States.