The standards were put together after two years of evaluation performed by the Coalition of Quality in Geriatric Surgery, which represents the American College of Surgeons and 58 stakeholder organizations.
Here are six things to know about the new standards.
1. Standards are a step above guidelines. “Guidelines are usually based on an evidence review and typically issued by professional societies or other expert panels. Standards … are more than recommendations — they are elevated to the level of care practices that are expected to be completed, and then verified by peer reviewers who evaluate whether the standards are being met and practiced appropriately in a clinical setting,” said Julia Berian, MD, the lead author.
2. The formation of the standards started in 2015, when stakeholders identified gaps in care for older surgical patients and brainstormed ideal future solutions around decision-making, perioperative optimization, clinical perioperative care and care transitions.
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3. The stakeholders reviewed and rated 308 proposed standards for validity and feasibility — nearly all (306) were rated as valid, and 290 were rated as feasible for implementation.
4. The existing preliminary standards are now in stage one of a two-stage pilot program. Fifteen end-user hospitals reviewed the standards in stage one, providing feedback to the CQGS on anticipated implementation challenges, identifying unclear standards and giving insight on how the standards could provide value to patients.
5. The second stage of the pilot will launch later this year, when six hospitals actually implement the standards.
6. After the pilot phases, a national verification program will be available. “As opposed to many of the outstanding clinically based quality improvement programs that target a specific disease, this program targets an enormous and increasing segment of our population,” said Clifford Y. Ko, MD, study coauthor. “To that end, except for pediatric hospitals, this program has the potential to capture all or nearly all hospitals in the country. But to truly have these standards widely accepted, it will be the local healthcare providers and facilities that will need to understand the importance of the resources and processes needed to optimally care for geriatric surgical patients.”
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