More than 40 percent of inpatient operations and 33 percent of outpatient procedures are performed on older adults each year in the United States. And that number is expected to mushroom as the boomer population ages (per a July 2019 article from AARP). To improve the surgical experience for patients 75 and older, the American College of Surgeons has released 30 patient-centered standards of care. It’s called the Geriatric Surgery Verification (GSV) Program. It was developed over a four-year period with input from over 50 stakeholders, including hospitals, patients, and providers.
“Since older patients potentially have a number of health issues and require more than one provider, medical personnel who participate in this new program create a team, including nurses, geriatricians, pharmacists, physical therapists and social workers, that would monitor the patient from pre-op to discharge” and beyond.
The success of the GSV program is built on improved communication between all parties on the team, including an emphasis on more sensitive communication between doctor and patient. A frequently heard complaint is that “surgeons don’t help older adults and their families understand the impact of surgery in terms people can understand, even though older patients face a higher risk of complications after surgery,” per an article from the Washington Post. Another concern is that surgeons often fail to “engage in ‘shared decision-making,’ which involves finding out what’s important to patients and discussing the surgery’s potential effect on their lives before setting a course for treatment.”
“A patient with a goal to live as long as possible may decide to opt for a major cancer surgery despite the risks. Another patient’s goal may focus on the quality of life over quantity of time,” said Clifford Y. Ko, M.D., director of the division of ASC research and optimal care in an interview with Fierce Healthcare. A priority is that “all older patients should have the opportunity to discuss their health goals and goals for the procedure, as well as their expectations for their recovery and their quality of life after surgery.”
The GSV Program standard also includes providing geriatric-friendly rooms, better management of medications, more detailed screening of geriatric vulnerabilities and other concerns that address the unique needs and desires of older adults. Hospital enrollment in the program is scheduled to begin in late October 2019 during the ACS Clinical Congress. The GSV Program standards can be found on the ACS website. For additional information, contact them via email: geratricsurgery@facs.org
Ken Teufel, M.D.
