The ‘University of California San Francisco (UCSF) Center for Surgery in Older Adults’ mission is to transform surgical care for older adult patients through discovery, evaluation, and implementation of best practices in geriatric surgery. The “Surgery Wellness Program (SWP)” launched in February 2015 and aims to transform the delivery of surgical care in the elderly by implementing and evaluating a comprehensive multidisciplinary care pathways that focuses on individualized risk assessment, patient-centered decision-making, functional optimization, and implementation of evidence-based geriatric perioperative best practices. The intervention combines a comprehensive geriatric preoperative assessment by an inter-professional team (i.e., medicine/geriatrician, dietician, occupational therapist, physical therapist, and a health coach) with creation and documentation of an individualized plan of care to optimize physiologic reserve. Patient self-reported outcomes document the patient’s current level of independence and functional status and their return to baseline function after surgery. Key preoperative and postoperative indicators such as length of stay, perioperative complications (i.e., geriatric syndromes, medical, and surgical complications), and 30-day readmission are the primary program outcomes. The goal is to inform care improvement in older surgical adults by identifying, refining, and standardizing best practices in surgical care for older adults. See: http://geriatric.surgery.ucsf.edu/wellness-program.aspx.
Three learning objectives for attendees:
By the end of the presentation the participant will be able to:
- Describe the epidemiology of geriatric surgery to include hospital utilization and the growing demand for surgical care among Americans age 65 or older.
- Describe components of patient-centered evidence-based best practice guidelines for optimal preoperative assessment of the geriatric surgical patient.
- List the components of the UCSF-SWP interprofessional geriatric preoperative prehabilitation intervention.