Optimizing the Feasibility and Scalability of a Geriatric Surgery Quality Improvement Initiative

Area of Science:

• Geriatric Surgery
• Quality Improvement
• Healthcare Management

Background:

• The American College of Surgeons Coalition for Quality in Geriatric Surgery developed standards to improve surgical care for older adults.
• Prior work validated 308 standards, but their hospital implementation feasibility was questioned.

Purpose of the Study:

• To enhance the scalability and generalizability of a geriatric surgery quality improvement program.
• To assess the feasibility of implementing existing quality improvement standards in hospitals.

Main Methods:

• A multi-institutional survey and interview process involving 15 hospitals.
• Hospitals' interdisciplinary panels evaluated standards for baseline implementation and perceived difficulty (Likert scale).
• Standards were categorized as "duplicative," "prohibitively difficult," or "high potential."

Main Results:

• Fifteen hospitals assessed 108 standards.
• 26% were found duplicative, 32% prohibitively difficult, and 42% high potential.
• 45% of standards were selected for the next iteration, with 64% of removed standards being duplicative or difficult.

Conclusions:

• A multi-institutional survey effectively identified redundant or difficult-to-implement care standards.
• These findings will improve the program's generalizability and scalability.
• The study supports the goal of enhancing surgical care for older adults.