Implementing specific protocols for older surgical patients can reduce complications such as delirium, falls, and pneumonia.
RT’s Three Key Takeaways:
- Targeted Screening Benefits: Proactive screening for delirium and fall risk factors significantly improves surgical outcomes and recovery for older adults.
- Protocol-Driven Care: The American College of Surgeons Geriatric Surgery Verification Program uses a seven-component protocol to prevent common complications like pneumonia and functional decline.
- Reduced Complications: Research indicates that hospitals implementing these standards see a 15% reduction in postoperative delirium and a 13% decrease in functional decline among older patients.
When care teams screen older adults undergoing surgery for risk factors such as falls and delirium, they improve outcomes for this vulnerable population, according to findings published in the Journal of the American College of Surgeons (JACS).
The study components form the basis of the American College of Surgeons (ACS) Geriatric Surgery Verification (GSV) Program’s older adult enhanced recovery protocol. This protocol focuses on preventing common complications such as delirium, falls, and pneumonia to help older patients recover safely and return to daily life.
“Surgery can be a challenging experience at any age, but older adults often face a higher risk of complications such as delirium, falls, or a prolonged recovery,” said Sarah Remer, MD, lead author of the study and a general surgery resident at Loyola University Medical Center, in a news release. “Our review suggests that when hospitals take proactive, targeted steps, such as routinely screening for delirium and carefully reviewing medication, we can make a real difference in helping our older patients get back to what matters most to them.”
The GSV protocol includes seven key components: delirium screening, medication review, fall risk assessment, nutrition and hydration management, early mobility, bowel and bladder management, and palliative care.
Dr Remer noted that simple, feasible steps—such as ensuring patients have access to eyeglasses and hearing aids or starting a bowel regimen—can prevent complications and improve recovery. These findings build on research demonstrating the value of implementing standards specifically for the healthcare needs of older adults.
“This ‘comprehensive’ review validates what we’ve seen in practice: the ACS Geriatric Surgery Verification Program provides a standardized, evidence-based approach that ‘transforms’ outcomes,” said Clifford Y Ko, MD, senior vice president of the ACS division of research and optimal patient care, in a news release. “By distilling a vast body of research into a practical protocol, we give hospitals a powerful tool to address the specific vulnerabilities of older adults, leading directly to safer care and shorter recoveries.”
To assist healthcare teams with implementation, the ACS offers the Early Planning of Small-Scale Surgical Improvement (EPoSSI) framework and a free patient checklist to guide conversations with surgical teams.
Data from previous studies show that hospitals implementing GSV standards achieved a 15% reduction in postoperative delirium and a 13% reduction in postoperative functional decline. Some studies also indicated lower mortality rates for patients treated under these standards.
