The American College of Surgeons Geriatric Surgery Verification Program and the Practicing Colorectal Surgeon

Zhang, Lindsey; Rosenthal, Ronnie A.; Finlayson, Emily; Russell, Marcia M.

doi:10.1016/j.scrs.2020.100779

Cited by 17 publications

(13 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5,16 Disincentivizing procedural care, decision support to flag patients with short-term mortality, and initiatives like the Geriatric Surgery Verification program with a clear requirement to document the "goals" of surgery, for example, "prolong life," rather than a reductionist "remove the colon," would all support improved care for older adults with life-limiting illnesses. 42 Our survey has several limitations. Even with a strong conceptual model and robust preliminary data, it is difficult to test underlying features of clinical care with a survey.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Provision of Nonbeneficial Surgery

Zaza

Zimmermann

Taylor³

et al. 2022

Annals of Surgery

View full text Add to dashboard Cite

Objective: We tested the association of systems factors with the surgeon’s likelihood of offering surgical intervention for older adults with life-limiting acute surgical conditions. Background: Use of surgical treatments in the last year of life is frequent. Improved risk prediction and clinician communication are solutions proposed to improve serious illness care, yet systems factors may also drive receipt of nonbeneficial treatment. Methods: We mailed a national survey to 5200 surgeons randomly selected from the American College of Surgeons database comprised of a clinical vignette describing a seriously ill older adult with an acute surgical condition, which utilized a 2×2 factorial design to assess patient and systems factors on receipt of surgical treatment to surgeons. Results: Two thousand one hundred sixty-one surgeons responded for a weighted response rate of 53%. For an 87-year-old patient with fulminant colitis and advanced dementia or stage IV lung cancer, 40% of surgeons were inclined to offer an operation to remove the patient’s colon while 60% were inclined to offer comfort-focused care only. Surgeons were more likely to offer surgery when an operating room was readily available (odds ratio: 4.05, P<0.001) and the family requests “do everything” (odds ratio: 2.18, P<0.001). Conclusions: Factors outside the surgeon’s control contribute to nonbeneficial surgery, consistent with our model of clinical momentum. Further characterization of the systems in which these decisions occur might expose novel strategies to improve serious illness care for older patients and their families.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors Associated With Provision of Nonbeneficial Surgery

Zaza

Zimmermann

Taylor³

et al. 2022

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…The goals of the CQGS were to (1) identify feasible and meaningful geriatric surgery-specific measures and (2) identify a systematic way to provide optimal care for older adults undergoing surgery with an emphasis on bringing stakeholders together. 30 The product of the CQGS was the Geriatric Surgery Verification Program (GSV). Development of the program entailed collaboration between over 50 different stakeholder organizations, completion of needs assessment, and multisite pilot program.…”

Section: American College Of Surgeons Geriatric Surgery Verification ...mentioning

confidence: 99%

“…As an overview, the GSV program includes a total of 30 mandatory and 2 optional standards which are grouped into four areas of focus: (1) goals of care and decision-making, (2) cognitive function and prevention of postoperative delirium, (3) maintenance of function and mobility, and (4) nutrition and hydration optimization. 30 The major components of the standards include 32 :…”

Section: Criteria For Accreditationmentioning

confidence: 99%

“…Operations on older adults account for nearly half of the operations done each year in the United States. 30 Recognizing that older adults have unique needs due to their overall frailty, comorbid conditions, social support, and overall survival, the ACS created the Coalition for Quality in Geriatric Surgery (CQGS). The goals of the CQGS were to (1) identify feasible and meaningful geriatric surgery-specific measures and (2) identify a systematic way to provide optimal care for older adults undergoing surgery with an emphasis on bringing stakeholders together.…”

Section: American College Of Surgeons Geriatric Surgery Verification ...mentioning

confidence: 99%

See 1 more Smart Citation

History and Role of Quality Accreditation

Russell

2023

Clin Colon Rectal Surg

View full text Add to dashboard Cite

Accreditation has played a major role in the evolution of health care quality as well as the structure and organization of American medicine. In its earliest iterations, accreditation aimed to set a minimum standard of care, and now more prominently sets standards for high quality, optimal patient care. There are several institutions that provide accreditations that are relevant to colorectal surgery including the American College of Surgeons (ACS) Commission on Cancer, National Cancer Institute Cancer Center Designation, National Accreditation Program for Rectal Cancer, and the ACS Geriatrics Verification Program. While each program has unique criteria, the aim of accreditation is to assure high-quality evidenced-based care. In addition to these benchmarks, these programs provide avenues for collaboration and research between centers and programs.

show abstract

“…The American College of Surgeons (ACS) Geriatric Surgery Verification (GSV) Programme presents 32 new surgical standards specifically designed to improve surgical care and outcomes for older adults. The standards provide a framework for a team approach of specialists from different disciplines, to continuously optimise care in this cohort and include guidance on pre- and postoperative management, importance of overall health goals, community outreach and education [ 86 ].…”

Section: Challenges and Potential Solutionsmentioning

confidence: 99%

Challenges in Geriatric Oncology—A Surgeon’s Perspective

Parks

Cheung

2022

Current Oncology

View full text Add to dashboard Cite

As our global population ages, we will see more cancer diagnoses in older adults. Surgery is an important treatment modality for solid tumours, forming the majority of all cancers. However, the management of older adults with cancer can be more complex compared to their younger counterparts. This narrative review will outline the current challenges facing older adults with cancer and potential solutions. The challenges facing older adults with cancer are complex and include lack of high-level clinical trials targeting older adults and selection of the right patient for surgery. This may be standard surgical treatment, minimally invasive surgery or alternative therapies (no surgery) which can be local or systemic. The next challenge is to identify the individual patient’s vulnerabilities to allow them to be maximally optimised for treatment. Prehabilitation has been shown to be of benefit in some cancer settings but uniform guidance across all surgical specialties is required. Greater awareness of geriatric conditions amongst surgical oncologists and integration of geriatric assessment into a surgical clinic are potential solutions. Enhanced recovery programmes tailored to older adults could reduce postoperative functional decline. Ultimately, the greatest challenge an older adult with cancer may face is the mindset of their treating clinicians—a shared care approach between surgical oncologists and geriatricians is required.

show abstract

The American College of Surgeons Geriatric Surgery Verification Program and the Practicing Colorectal Surgeon

Cited by 17 publications

References 40 publications

Factors Associated With Provision of Nonbeneficial Surgery

Factors Associated With Provision of Nonbeneficial Surgery

History and Role of Quality Accreditation

Challenges in Geriatric Oncology—A Surgeon’s Perspective

Contact Info

Product

Resources

About