• J. Am. Coll. Surg. · Aug 2023

    Multi-Site Implementation of an American College of Surgeons Geriatric Surgery Quality Improvement Initiative.

    • Meixi Ma, Xane D Peters, Lindsey M Zhang, Melissa Hornor, Kataryna Christensen, JoAnn Coleman, Emily Finlayson, Kellie L Flood, Mark Katlic, Sandhya Lagoo-Deenadayalan, Thomas N Robinson, Ronnie A Rosenthal, Victoria L Tang, Clifford Y Ko, and Marcia M Russell.
    • From the Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL (Ma, Peters, Zhang, Christensen, Ko).
    • J. Am. Coll. Surg. 2023 Aug 1; 237 (2): 171181171-181.

    BackgroundThe American College of Surgeons (ACS) Coalition for Quality in Geriatric Surgery (CQGS) identified standards of surgical care for the growing, vulnerable population of aging adults in the US. The aims of this study were to determine implementation feasibility for 30 selected standards, identify barriers and best practices in their implementation, and further refine these geriatric standards and verification process.Study DesignThe CQGS requested participation from hospitals involved in the ACS NSQIP Geriatric Surgery Pilot Project, previous CQGS feasibility analyses, and hospitals affiliated with a core development team member. Thirty standards were selected for implementation. After implementation, site visits were conducted, and postvisit surveys were distributed.ResultsEight hospitals were chosen to participate. Program management (55%), immediate preoperative and intraoperative clinical care (62.5%), and postoperative clinical care (58%) had the highest mean percentage of "fully compliant" standards. Goals and decision-making (30%), preoperative optimization (28%), and transitions of care (12.5%) had the lowest mean percentage of fully compliant standards. Best practices and barriers to implementation were identified across 13 of the 30 standards. More than 80% of the institutions reported that participation changed the surgical care provided for older adults.ConclusionsThis study represents the first national implementation assessment undertaken by the ACS for one of its quality programs. The CQGS pilot testing was able to demonstrate implementation feasibility for 30 standards, identify challenges and best practices, and further inform dissemination of the ACS Geriatric Surgery Verification Program.Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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