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Developing quality indicators for elderly surgical patients.

Marcia L McGory¹, Kenneth K Kao, Paul G Shekelle

¹Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-6904, USA. mmcgory@mednet.ucla.edu

Annals of Surgery

|July 30, 2009

Summary

This summary is machine-generated.

Developing quality indicators for elderly surgical patients is crucial. This study identified 91 valid process measures to enhance perioperative care and outcomes for this growing demographic.

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Area of Science:

Geriatric Surgery
Perioperative Medicine
Quality Improvement

Background:

The global population is aging, increasing the demand for surgical services for elderly patients.
Optimizing surgical care for older adults is essential to meet future healthcare needs.
There is a need for standardized measures to improve surgical care for the elderly.

Purpose of the Study:

To develop process-based quality indicators for perioperative care in elderly surgical patients.
To identify meaningful ways to improve surgical care and outcomes for older adults.
To create applicable indicators across all surgical disciplines.

Main Methods:

Candidate perioperative quality indicators were identified through expert interviews and literature reviews.
An expert panel rated indicators using a modified RAND/UCLA Appropriateness Methodology.
Indicators were developed for ambulatory, inpatient elective, and inpatient nonelective surgeries.

Main Results:

91 out of 96 candidate indicators were validated.
Indicators were organized into 8 domains: comorbidity assessment, elderly issues, medication use, patient-provider discussions, intraoperative care, postoperative management, discharge planning, and ambulatory surgery.
78% of validated indicators address processes unique to elderly surgical populations.

Conclusions:

High-quality perioperative care for elderly patients is paramount due to increasing surgical volumes.
A validated methodology was employed to identify and rate process measures for optimal elderly surgical care.
These indicators provide a framework for improving the quality of care for older adults undergoing surgery.