Hackensack University Medical Center Launches Pilot Geriatric Surgery Program in Commitment Phase of ACS Geriatric Surgery Verification
Quality improvement program enrolls first 16 geriatric surgery patients
Hackensack Meridian Hackensack University Medical Center, currently in Commitment Level status in the American College of Surgeons Geriatric Surgery Verification (GSV) Program, has launched a pilot geriatric surgery program and enrolled 16 patients to date.
The team is applying EPIC optimizations to enhance geriatric surgical patient assessments during this pilot phase, in preparation for completing the GSV survey. The team is already making refinements, such as potentially merging assessments with pre-op blood work to eliminate the need for an additional visit.
Created in July 2019, the GSV program is a quality improvement program that provides a framework for the delivery of optimal care and achievement of the best outcomes for geriatric patients undergoing surgery. Hackensack University Medical Center is among only 8 hospitals in the region to participate in this initiative.
“As a verified geriatric surgery facility, the surgical care team at Hackensack University Medical Center is implementing the program standards to continuously make the most effective use of surgical care for a vulnerable aging population,” said Lisa K. Tank, M.D., Chief Medical Officer at Hackensack University Medical Center and Assistant Professor at Hackensack Meridian School of Medicine, who is board-certified in geriatrics, and internal medicine. “By assessing preoperative risks, we are able to provide anticipatory care that is tailored to older adults to help them meet their individual goals of surgery as well as speedy recovery.”
Hackensack University Medical Center started the journey for this verification in January 2021 with electronic health record optimization to improve clinical productivity, efficiency and create protocols establishing adequate resources. The center held its first interdisciplinary patient conference in November 2022.
Through the verification program, the medical center is fortifying its geriatric surgical care systems to achieve surgical excellence using:
- Geriatric vulnerability screens
- Management plan for vulnerabilities
- Interdisciplinary input for high-risk elective surgery
- Process for flagging and reviewing high-risk medications
- Geriatric interdisciplinary management for high-risk patients
"Older patients account for 40 percent of hospital inpatient surgical procedures and 30 percent of outpatient procedures. With the graying of the population, those numbers will continue to grow," explained Manisha S. Parulekar, M.D., Chief of the Division of Geriatric Medicine at Hackensack University Medical Center.
Practices to support older surgical patients at Hackensack University Medical Center include a preoperative evaluation by a geriatric provider trained to evaluate specific needs, such as those related to pain relief, cognitive skills, nutrition, with results addressed preoperatively and throughout the hospital stay by a multidisciplinary team. Tailored care can include nurse-led initiatives to get patients out of bed soon to preserve muscle strength; ensuring hearing aids, dentures and glasses are returned immediately after surgery; referral to the HELP program, diverse pain management options; and proactive discharge planning.
The Geriatric Surgery Verification Quality Improvement Program anticipated outcomes include: implementation of evidence-based standards; strengthened interdisciplinary care and communication; improved implementation of protocol-based care; improved clinical outcomes and patient satisfaction; and better results in any payment/incentive models.
Learn more about innovative geriatric care at Hackensack University Medical Center.
