The expanding and aging population will likely increase demand for surgical services.
However, surgeons and other providers must develop strategies to optimize care.
Dr Marcia McGory and colleagues from Los Angeles developed process-based quality indicators for elderly patients after abdominal operations.
The investigative team identified necessary and meaningful ways to improve care in this cohort.
The team conducted structured interviews with thought leaders and systematic reviews of the literature.
|89 candidate indicators were identified and categorized into 7 domains|
|Journal of the American College of Surgeons|
Candidate quality indicators addressing perioperative care in elderly patients undergoing abdominal operations was identified.
The investigators used a modification of the RAND/UCLA Appropriateness Methodology.
An expert panel of physicians in surgery, geriatrics, anesthesia, internal, and rehabilitation medicine formally rated and discussed the indicators.
The team identified 89 candidate indicators were identified and categorized into 7 domains.
These included comorbidity assessment, elderly issues, medication use, patient-to-provider discussions, and intraoperative care.
The investigators also identified postoperative management, and discharge planning as categories.
Of the 89 candidate indicators, 76 were rated as valid by the expert panel.
Importantly, the majority of indicators rated as valid address processes of care not routinely performed in younger surgical populations.
Dr McGory's team commented, “Attention to the quality of surgical care in elderly patients is of great importance because of the increasing numbers of elderly undergoing operations.”
“This project used a validated methodology to identify and rate process measures to achieve high-quality perioperative care for elderly surgical patients.”
“This is the first time quality indicators have been developed in this regard.”