“Now that we’ve confirmed
what high-quality surgical care
for older adults should look
like, we’re ready to evaluate
how these standards will work
in a hospital environment.
This is an important aspect of
the project, and the feedback
portion from hospitals is
vitally important,” said Ronnie
Rosenthal, MD, MS, FACS, CQGS
The alpha pilot phase launched
in January and is now in its
final stages. Fifteen end-user
hospitals reviewed the standards
to provide feedback to CQGS
on anticipated challenges
in meeting the standards,
identifying unclear standards,
and gaining insight on the value
of implementing these standards
in their hospital environment
and with their patients.
“Although feasibility of
implementation may be a
challenge for some hospitals, the
CQGS continues to explore ways
to make these standards flexible
across different hospital settings,
sizes, and resource levels. Our
alpha pilot will elicit real-world
feedback from frontline hospitals
and providers about these
standards,” Dr. Berian said.
A beta pilot phase will
follow in late 2017, and will
engage six hospitals to actually
implement the standards for
older surgical patients.
Once the pilot phases have
been completed and a national
verification program is available,
participating hospitals will make
the commitment to ensure
that geriatric surgical quality is
interconnected with a hospital’s
quality and safety culture.
This program shows great
potential to transform surgery
for older adults across the
nation, according to Dr. Ko.
“As opposed to many of the
outstanding clinically based
quality improvement programs
that target a specific disease, this
program targets an enormous
and increasing segment of
our population,” he said. “To
that end, except for pediatric
hospitals, this program has the
potential to capture all or nearly
all hospitals in the country. But
to truly have these standards
widely accepted, it will be the
local health care providers
and facilities that will need to
understand the importance of
the resources and processes
needed to optimally care for
geriatric surgical patients.” ♦
1. U.S. Census Bureau. 2014 national
population projections summary
tables. Table 6: Percent distribution of
the projected population by sex and
selected age groups for the U.S.: 2015
to 2060. Available at: www.census.
Accessed May 9, 2017.
2. Centers for Disease Control and
Prevention. Number of discharges
from short-stay hospitals, by first-listed diagnosis and age: United States,
2010. Available at: www.cdc.gov/nchs/
numberage.pdf. Accessed May 9, 2017.
3. Mohanty S, Rosenthal RA, Russell
MM, et al. Optimal perioperative
management of the geriatric patient:
A best practices guideline from the
American College of Surgeons NSQIP
and the American Geriatrics Society.
J Am Coll Surg. 2016;222( 5):930-947.
Accessed April 21, 2017.
4. 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. Accessed
April 21, 2017.
Once the pilot phases have been completed and a national
verification program is available, participating hospitals will
make the commitment to ensure that geriatric surgical quality
is interconnected with a hospital’s quality and safety culture.